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1.
Radiol Med ; 125(8): 738-753, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: covidwho-597679

RESUMEN

Ultrasound is the most disruptive innovation in intensive care life, above all in this time, with a high diagnostic value when applied appropriately. In recent years, point-of-care lung ultrasound has gained significant popularity as a diagnostic tool in the acutely dyspnoeic patients. In the era of Sars-CoV-2 outbreak, lung ultrasound seems to be strongly adapting to the follow-up for lung involvement of patients with ascertaining infections, till to be used, in our opinion emblematically, as a screening test in suspected patients at the emergency triage or at home medical visit. In this brief review, we discuss the lung ultrasound dichotomy, certainties and uncertainties, describing its potential role in validated clinical contexts, as a clinical-dependent exam, its limits and pitfalls in a generic and off-label clinical context, as a virtual anatomical-dependent exam, and its effects on the clinical management of patients with COVID-19.


Asunto(s)
Artefactos , Infecciones por Coronavirus/diagnóstico por imagen , Neumonía Viral/diagnóstico por imagen , Ultrasonografía/métodos , Betacoronavirus , Diagnóstico Diferencial , Humanos , Pandemias , Sistemas de Atención de Punto , Sensibilidad y Especificidad
2.
Arch Cardiol Mex ; 90(Supl): 15-18, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-595911

RESUMEN

The SARS-CoV-2 infection has as a clinical manifestation the disease known as COVID-19. Although knowledge of the nature of the disease is dynamic, with dozens of scientific articles being published every day about new features of COVID-19, the typical presentation is that of interstitial pneumonia. Despite the large amount of information that has been developed in recent weeks, it has been estimated that this disease can have up to 72% underdiagnosis, which requires clinical tools that are simple, easily accessible, and increase the detection of cases in a feasible way and that yield information with prognostic value. Given this need, some proposals have emerged to be able to diagnose, monitor and respond to the treatment of patients with COVID-19, such as pulmonary ultrasound (USP). It is worth mentioning that the USP has proven to be an efficient and easily reproducible technique for diagnosing heart failure and pleuro-pulmonary pathologies, especially in critically ill patients. Evidence of the usefulness of USP in COVID-19 is still scarce, although preliminary, it seems to be a sensitive technique whose findings have a high gold standard. In this brief review we will emphasize its technical aspects, the advantages and disadvantages, and finally a proposal for the approach in this type of patient.


Asunto(s)
Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico por imagen , Neumonía Viral/diagnóstico por imagen , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/diagnóstico , Enfermedad Crítica , Humanos , Enfermedades Pulmonares Intersticiales/diagnóstico por imagen , Enfermedades Pulmonares Intersticiales/virología , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/virología , Reproducibilidad de los Resultados , Ultrasonografía/métodos
4.
Zhonghua Er Ke Za Zhi ; 58(5): 347-350, 2020 May 02.
Artículo en Chino | MEDLINE | ID: covidwho-248777

RESUMEN

Objective: To investigate the application of pulmonary ultrasound in the diagnosis of neonatal COVID-19. Methods: In this retrospective study, the clinical data of 5 infants, who were admitted to the Department of Neonatology in Wuhan Children's Hospital from 31(st) January to 25(th) February 2020, were collected. Bedsides pulmondary ultrasound was conducted on admission, during the hospitalization, and before discharge, the result were compared with the chest X-ray or CT done at the same time. Results: Among the 5 cases who aged 1-18 days, 3 were male. The main clinical manifestations were respiratory and gastrointestinal symptoms. The pulmonary ultrasonography on admission showed abnormal pleural line and pulmonary edema of different severity in all 5 cases, presented as increase and fusion of B-line, and pulmonary interstitial syndrome; among them, one case also had a small-range consolidation. The chest CT on admission showed no obvious parenchymal infiltration in 2 cases, small strip or patchy high-density shadow in 2 cases, and ground glass change in one case. The re-examination of ultrosound during the hospitalization and at discharge showed improvement in all cases and were consistent with the chest X-ray taken at the same time. Conclusions: The main changes on the pulmonary ultrasonography in neonates with COVID-19 pneumonia are increase and fusion of B-line, abnormal pleural line, and alveolar interstitial syndrome, and may coexist with small range of pulmonary consolidation. The sensitivity of pulmonary ultrasound is higher than that of chest X-ray and CT in the diagnosis of pulmonary edema, and could be used in monitoring and evaluation of the disease.


Asunto(s)
Infecciones por Coronavirus , Coronavirus , Pulmón/diagnóstico por imagen , Pandemias , Neumonía Viral , Tórax/diagnóstico por imagen , Ultrasonografía/métodos , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Hospitalización , Humanos , Recién Nacido , Masculino , Neumonía Viral/epidemiología , Estudios Retrospectivos , Tomografía Computarizada por Rayos X
5.
Clin Med (Lond) ; 20(4): e62-e65, 2020 07.
Artículo en Inglés | MEDLINE | ID: covidwho-245760

RESUMEN

INTRODUCTION: Coronavirus disease 2019 (COVID-19) is a highly contagious illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Pneumonia and acute respiratory distress syndrome (ARDS) are the most common severe complications. There is growing evidence regarding the imaging findings of COVID-19 in chest X-rays and computed tomography (CT); however, their availability to clinical staff in this pandemic outbreak might be compromised. At this moment, the role of lung ultrasound (LUS) has yet to be explored. The purpose of this case report is to describe the natural course of the disease in mild infection managed at home. CASE REPORT: We report a 35-year-old man with recently diagnosed COVID-19 infection. Clinical examination was unremarkable. The diagnosis of mild disease was made clinically which was later reaffirmed by LUS after identifying a bilateral small pleural effusion and a thickened pleural line. During follow up, subpleural consolidations appeared before symptoms slightly aggravated (cough, tiredness and fever). The patient's condition improved after adjustment of therapy at home. CONCLUSION: LUS is an excellent tool in the characterisation of COVID-19 infection and is more available than CT or X-ray. We emphasise the utility and the opportunity that LUS presents in some clinical scenarios, like this COVID-19 pandemic, and how it may serve as a monitoring and therapy guide.


Asunto(s)
Infecciones por Coronavirus , Servicios de Atención de Salud a Domicilio/organización & administración , Pulmón/diagnóstico por imagen , Pandemias , Derrame Pleural , Neumonía Viral , Sistemas de Atención de Punto , Ultrasonografía/métodos , Adulto , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/fisiopatología , Infecciones por Coronavirus/terapia , Accesibilidad a los Servicios de Salud , Humanos , Masculino , Monitoreo Fisiológico/métodos , Derrame Pleural/diagnóstico , Derrame Pleural/etiología , Neumonía Viral/diagnóstico , Neumonía Viral/fisiopatología , Neumonía Viral/terapia , Índice de Severidad de la Enfermedad , Evaluación de Síntomas/métodos , Resultado del Tratamiento
6.
Ultrasound Med Biol ; 46(8): 2090-2093, 2020 08.
Artículo en Inglés | MEDLINE | ID: covidwho-186451

RESUMEN

Lung ultrasound gained a leading position in the last year as an imaging technique for the assessment and management of patients with acute respiratory failure. In coronavirus disease 2019 (COVID-19), its role may be of further importance because it is performed bedside and may limit chest X-ray and the need for transport to radiology for computed tomography (CT) scan. Since February 21, we progressively turned into a coronavirus-dedicated intensive care unit and applied an ultrasound-based approach to avoid traditional imaging and limit contamination as much as possible. We performed a complete daily examination with lung ultrasound score computation and systematic search of complications (pneumothorax, ventilator-associated pneumonia); on-duty physicians were free to perform CT or chest X-ray when deemed indicated. We compared conventional imaging exams performed in the first 4 wk of the COVID-19 epidemic with those in the same time frame in 2019: there were 84 patients in 2020 and 112 in 2019; 64 and 22 (76.2% vs. 19.6%, p < 0.001) had acute respiratory failure, respectively, of which 55 (85.9%) were COVID-19 in 2020. When COVID-19 patients in 2020 were compared with acute respiratory failure patients in 2019, the median number of chest X-rays was 1.0 (1.0-2.0) versus 3.0 (1.0-4.0) (p = 0.0098); 2 patients 2 (3.6%) versus 7 patients (31.8%) had undergone at least one thoracic CT scan (p = 0.001). A self-imposed ultrasound-based approach reduces the number of chest X-rays and thoracic CT scans in COVID-19 patients compared with patients with standard acute respiratory failure, thus reducing the number of health care providers exposed to possible contamination and sparing personal protective equipment.


Asunto(s)
Infecciones por Coronavirus/diagnóstico por imagen , Exposición Profesional/prevención & control , Neumonía Viral/diagnóstico por imagen , Insuficiencia Respiratoria/diagnóstico por imagen , Ultrasonografía/métodos , Anciano , Betacoronavirus , Femenino , Humanos , Pulmón/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Pandemias
7.
Ultrasound Med Biol ; 46(8): 2094-2098, 2020 08.
Artículo en Inglés | MEDLINE | ID: covidwho-154614

RESUMEN

Recent evidence indicates the usefulness of lung ultrasound (LUS) in detecting coronavirus disease 19 (COVID-19) pneumonia. However, no data are available on the use of LUS in children with COVID-19 pneumonia. In this report, we describe LUS features of 10 consecutively admitted children with COVID-19 in two tertiary-level pediatric hospitals in Rome. LUS revealed signs of lung involvement during COVID-19 infection. In particular, vertical artifacts (70%), pleural irregularities (60%), areas of white lung (10%) and subpleural consolidations (10%) were the main findings in patients with COVID-19. No cases of pleural effusions were found. According to our experience, the routine use of LUS in the evaluation of children with suspected or confirmed COVID-19, when performed by clinicians with documented experience in LUS, was useful in diagnosing and monitoring pediatric COVID-19 pneumonia, reducing unnecessary radiation/sedation in children and exposure of health care workers to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).


Asunto(s)
Infecciones por Coronavirus/diagnóstico por imagen , Exposición Profesional/prevención & control , Neumonía Viral/diagnóstico por imagen , Ultrasonografía/métodos , Adolescente , Betacoronavirus , Niño , Preescolar , Femenino , Hospitales Pediátricos , Humanos , Pulmón/diagnóstico por imagen , Masculino , Pandemias , Roma
9.
Arch Bronconeumol ; 56 Suppl 2: 27-30, 2020 07.
Artículo en Inglés, Español | MEDLINE | ID: covidwho-138325

RESUMEN

The great pulmonary affectation produced by the COVID-19 infection, requires a fast diagnostic tool that complements the diagnostic test by PCR and which is also useful in evaluating the progression of lung lesions. Since most of these are peripheral, in this consensus document we propose the use of thoracic ultrasound for early diagnosis and for the daily evaluation of the progression of lung lesions by a single explorer without the need to use the chest CT. In this consensus, it is proposed to carry out a systematic ultrasound examination of the thorax dividing it by quadrants and therefore identifying the ultrasound signs that are related to the type of parenchymal or pleural affectation that the patient has: A lines, B lines, parenchymal condensation, pleural line and pleural effusion. These findings will facilitate the decision making regarding the patient management, both when deciding the place of admission of the patient and the type of treatment to be prescribed.


Asunto(s)
Betacoronavirus , Consenso , Infecciones por Coronavirus/diagnóstico por imagen , Pulmón/diagnóstico por imagen , Neumonía Viral/diagnóstico por imagen , Ultrasonografía/métodos , Toma de Decisiones Clínicas , Infecciones por Coronavirus/complicaciones , Progresión de la Enfermedad , Humanos , Pandemias , Posicionamiento del Paciente/métodos , Neumonía Viral/complicaciones , Sociedades Médicas , España , Tórax/diagnóstico por imagen , Ultrasonografía/instrumentación
10.
Otolaryngol Head Neck Surg ; 163(1): 51-53, 2020 07.
Artículo en Inglés | MEDLINE | ID: covidwho-133457

RESUMEN

The novel coronavirus disease (COVID-19), caused by the SARS-CoV-2 virus, has quickly become a global pandemic since its initial outbreak in China in late 2019. Institutions are faced with the challenge of upholding the standard of care while maintaining safety for health care personnel and patients. Due to the common performance of aerosol-generating endoscopic procedures in the upper respiratory tract, otolaryngologists are at uniquely high risk for potential infection. When possible, alternative diagnostic and treatment strategies should be pursued. For patients suspected of having functional laryngeal abnormalities, transcervical laryngeal ultrasound provides a rapid and noninvasive evaluation of vocal fold motion to inform decisions about safety of feeding, airway, and progression of care.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Transmisión de Enfermedad Infecciosa/prevención & control , Enfermedades de la Laringe/diagnóstico , Laringe/diagnóstico por imagen , Neumonía Viral/epidemiología , Ultrasonografía/métodos , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/transmisión , Humanos , Enfermedades de la Laringe/complicaciones , Cuello , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/transmisión
13.
Anaesthesia ; 75(8): 1096-1104, 2020 08.
Artículo en Inglés | MEDLINE | ID: covidwho-46248

RESUMEN

Ultrasound imaging of the lung and associated tissues may play an important role in the management of patients with COVID-19-associated lung injury. Compared with other monitoring modalities, such as auscultation or radiographic imaging, we argue lung ultrasound has high diagnostic accuracy, is ergonomically favourable and has fewer infection control implications. By informing the initiation, escalation, titration and weaning of respiratory support, lung ultrasound can be integrated into COVID-19 care pathways for patients with respiratory failure. Given the unprecedented pressure on healthcare services currently, supporting and educating clinicians is a key enabler of the wider implementation of lung ultrasound. This narrative review provides a summary of evidence and clinical guidance for the use and interpretation of lung ultrasound for patients with moderate, severe and critical COVID-19-associated lung injury. Mechanisms by which the potential lung ultrasound workforce can be deployed are explored, including a pragmatic approach to training, governance, imaging, interpretation of images and implementation of lung ultrasound into routine clinical practice.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/diagnóstico por imagen , Pulmón/diagnóstico por imagen , Neumonía Viral/diagnóstico por imagen , Sistemas de Atención de Punto , Competencia Clínica , Humanos , Capacitación en Servicio/métodos , Pandemias , Ultrasonografía/métodos , Ultrasonografía/normas
14.
J Cardiothorac Vasc Anesth ; 34(7): 1727-1732, 2020 07.
Artículo en Inglés | MEDLINE | ID: covidwho-45999

RESUMEN

The COVID-19 pandemic is spreading globally. COVID-19 has an effect on the systemic state, cardiopulmonary function and primary disease of patients undergoing surgery. COVID-19's high contagiousness makes anesthesia and intraoperative management more difficult. This expert consensus aims to comprehensively introduce the application of perioperative ultrasound in COVID-19 patients, including pulmonary ultrasound and anesthesia management, ultrasound and airway management, ultrasound-guided regional anesthesia and echocardiography for COVID-19 patients.


Asunto(s)
Anestesia/métodos , Betacoronavirus , Infecciones por Coronavirus/diagnóstico por imagen , Atención Perioperativa/métodos , Neumonía Viral/diagnóstico por imagen , Ultrasonografía/métodos , Manejo de la Vía Aérea/métodos , Anestesia de Conducción/métodos , Enfermedades Cardiovasculares/complicaciones , Enfermedades Cardiovasculares/diagnóstico por imagen , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/transmisión , Ecocardiografía/métodos , Hemodinámica , Humanos , Pulmón/diagnóstico por imagen , Enfermedades Pulmonares/diagnóstico por imagen , Enfermedades Pulmonares/microbiología , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/transmisión , Traqueotomía/métodos , Ultrasonografía Intervencional/métodos , Desconexión del Ventilador/métodos
17.
Ultrasound Obstet Gynecol ; 55(6): 835-837, 2020 06.
Artículo en Inglés | MEDLINE | ID: covidwho-34937

RESUMEN

Imaging modalities play a crucial role in the management of suspected COVID-19 patients. Before reverse transcription polymerase chain reaction (RT-PCR) test results are positive, 60-93% of patients have positive chest computed tomographic (CT) findings consistent with COVID-19. We report a case of positive lung ultrasound findings consistent with COVID-19 in a woman with an initially negative RT-PCR result. The lung ultrasound-imaging findings were present between the negative and subsequent positive RT-PCR tests and correlated with CT findings. The point-of-care lung-ultrasound examination was easy to perform and, as such, could play an important role in the triage of women with suspected COVID-19. The neonatal swabs, cord blood and placental swab RT-PCR tests were negative for SARS-CoV-2, a finding consistent with the published literature suggesting no vertical transmission of this virus in pregnant women. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.


Asunto(s)
Infecciones por Coronavirus/diagnóstico por imagen , Pulmón/diagnóstico por imagen , Neumonía Viral/diagnóstico por imagen , Complicaciones Infecciosas del Embarazo/diagnóstico por imagen , Ultrasonografía/métodos , Adulto , Cesárea , Angiografía por Tomografía Computarizada , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/terapia , Diagnóstico Diferencial , Femenino , Sangre Fetal/virología , Humanos , Leche Humana/virología , Pandemias , Placenta/virología , Neumonía Viral/diagnóstico , Neumonía Viral/terapia , Pruebas en el Punto de Atención , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico , Complicaciones Infecciosas del Embarazo/terapia , Embolia Pulmonar/diagnóstico , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Tomografía Computarizada por Rayos X
18.
Arch Bronconeumol ; 56 Suppl 2: 27-30, 2020 07.
Artículo en Inglés, Español | MEDLINE | ID: covidwho-27702

RESUMEN

The great pulmonary affectation produced by the COVID-19 infection, requires a fast diagnostic tool that complements the diagnostic test by PCR and which is also useful in evaluating the progression of lung lesions. Since most of these are peripheral, in this consensus document we propose the use of thoracic ultrasound for early diagnosis and for the daily evaluation of the progression of lung lesions by a single explorer without the need to use the chest CT. In this consensus, it is proposed to carry out a systematic ultrasound examination of the thorax dividing it by quadrants and therefore identifying the ultrasound signs that are related to the type of parenchymal or pleural affectation that the patient has: A lines, B lines, parenchymal condensation, pleural line and pleural effusion. These findings will facilitate the decision making regarding the patient management, both when deciding the place of admission of the patient and the type of treatment to be prescribed.


Asunto(s)
Betacoronavirus , Consenso , Infecciones por Coronavirus/diagnóstico por imagen , Pulmón/diagnóstico por imagen , Neumonía Viral/diagnóstico por imagen , Ultrasonografía/métodos , Toma de Decisiones Clínicas , Infecciones por Coronavirus/complicaciones , Progresión de la Enfermedad , Humanos , Pandemias , Posicionamiento del Paciente/métodos , Neumonía Viral/complicaciones , Sociedades Médicas , España , Tórax/diagnóstico por imagen , Ultrasonografía/instrumentación
19.
Eur Rev Med Pharmacol Sci ; 24(5): 2776-2780, 2020 03.
Artículo en Inglés | MEDLINE | ID: covidwho-11541

RESUMEN

An outbreak of a novel coronavirus disease-19 (nCoV-19) infection began in December 2019 in Wuhan, China, and now involved the whole word. Several health workers have been infected in different countries. We report the case of a young man with documented nCoV-19 infection evaluated with lung ultrasound and discuss potential applications of lung ultrasound in this setting. Lung ultrasound allowed the identification of nCoV-19 infection at bed-side. Moreover, lung ultrasound can have several other advantages, such as reduced health worker exposition to infected patients, repeatability during follow-up, low-costs and easier application in low-resource settings.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/diagnóstico por imagen , Neumonía Viral/diagnóstico por imagen , Sistemas de Atención de Punto , Ultrasonografía/métodos , Humanos , Pulmón/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Pandemias
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