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1.
Br J Radiol ; 94(1119): 20200755, 2021 Mar 01.
Artículo en Inglés | MEDLINE | ID: covidwho-999783

RESUMEN

COVID-19 can cause damage to the lung, which can result in progressive respiratory failure and potential death. Chest radiography and CT are the imaging tools used to diagnose and monitor patients with COVID-19. Lung ultrasound (LUS) during COVID-19 is being used in some areas to aid decision-making and improve patient care. However, its increased use could help improve existing practice for patients with suspected COVID-19, or other lung disease. A limitation of LUS is that it requires practitioners with sufficient competence to ensure timely, safe, and diagnostic clinical/imaging assessments. This commentary discusses the role and governance of LUS during and beyond the COVID-19 pandemic, and how increased education and training in this discipline can be undertaken given the restrictions in imaging highly infectious patients. The use of simulation, although numerical methods or dedicated scan trainers, and machine learning algorithms could further improve the accuracy of LUS, whilst helping to reduce its learning curve for greater uptake in clinical practice.


Asunto(s)
/diagnóstico por imagen , Neumonía Viral/diagnóstico por imagen , Radiología/educación , Ultrasonografía/métodos , Competencia Clínica , Humanos , Aprendizaje Automático , Pandemias , Neumonía Viral/virología , Sistemas de Atención de Punto
2.
BMJ Case Rep ; 13(12)2020 Dec 22.
Artículo en Inglés | MEDLINE | ID: covidwho-999235

RESUMEN

Intra-abdominal thromboses are a poorly characterised thrombotic complication of COVID-19 and are illustrated in this case. A 42-year-old man with chronic hepatitis B (undetectable viral load, FibroScan 7.4 kPa) developed fever and cough in March 2020. 14 days later, he developed right upper quadrant pain. After being discharged with reassurance, he re-presented with worsening pain on symptom day 25. Subsequent abdominal ultrasound suggested portal vein thrombosis. CT of the abdomen confirmed portal and mid-superior mesenteric vein thromboses. Concurrent CT of the chest suggested COVID-19 infection. While reverse transcription PCR was negative, subsequent antibody serology was positive. Thrombophilia screen excluded inherited and acquired thrombophilia. Having been commenced on apixaban 5 mg two times per day, he is currently asymptomatic. This is the first case of COVID-19-related portomesenteric thrombosis described in the UK. A recent meta-analysis suggests 9.2% of COVID-19 cases develop abdominal pain. Threshold for performing abdominal imaging must be lower to avoid this reversible complication.


Asunto(s)
Hepatitis B Crónica/complicaciones , Isquemia Mesentérica , Venas Mesentéricas/diagnóstico por imagen , Vena Porta/diagnóstico por imagen , Pirazoles/administración & dosificación , Piridonas/administración & dosificación , /aislamiento & purificación , Dolor Abdominal/diagnóstico , Adulto , /complicaciones , /métodos , Diagnóstico Diferencial , Inhibidores del Factor Xa/administración & dosificación , Humanos , Masculino , Isquemia Mesentérica/etiología , Isquemia Mesentérica/fisiopatología , Isquemia Mesentérica/terapia , Portografía/métodos , Tomografía Computarizada por Rayos X/métodos , Resultado del Tratamiento , Ultrasonografía/métodos
3.
Crit Care ; 24(1): 700, 2020 12 22.
Artículo en Inglés | MEDLINE | ID: covidwho-992530

RESUMEN

BACKGROUND: Bedside lung ultrasound (LUS) has emerged as a useful and non-invasive tool to detect lung involvement and monitor changes in patients with coronavirus disease 2019 (COVID-19). However, the clinical significance of the LUS score in patients with COVID-19 remains unknown. We aimed to investigate the prognostic value of the LUS score in patients with COVID-19. METHOD: The LUS protocol consisted of 12 scanning zones and was performed in 280 consecutive patients with COVID-19. The LUS score based on B-lines, lung consolidation and pleural line abnormalities was evaluated. RESULTS: The median time from admission to LUS examinations was 7 days (interquartile range [IQR] 3-10). Patients in the highest LUS score group were more likely to have a lower lymphocyte percentage (LYM%); higher levels of D-dimer, C-reactive protein, hypersensitive troponin I and creatine kinase muscle-brain; more invasive mechanical ventilation therapy; higher incidence of ARDS; and higher mortality than patients in the lowest LUS score group. After a median follow-up of 14 days [IQR, 10-20 days], 37 patients developed ARDS, and 13 died. Patients with adverse outcomes presented a higher rate of bilateral involvement; more involved zones and B-lines, pleural line abnormalities and consolidation; and a higher LUS score than event-free survivors. The Cox models adding the LUS score as a continuous variable (hazard ratio [HR]: 1.05, 95% confidence intervals [CI] 1.02 ~ 1.08; P < 0.001; Akaike information criterion [AIC] = 272; C-index = 0.903) or as a categorical variable (HR 10.76, 95% CI 2.75 ~ 42.05; P = 0.001; AIC = 272; C-index = 0.902) were found to predict poor outcomes more accurately than the basic model (AIC = 286; C-index = 0.866). An LUS score cut-off > 12 predicted adverse outcomes with a specificity and sensitivity of 90.5% and 91.9%, respectively. CONCLUSIONS: The LUS score devised by our group performs well at predicting adverse outcomes in patients with COVID-19 and is important for risk stratification in COVID-19 patients.


Asunto(s)
/diagnóstico por imagen , Neumonía Viral/diagnóstico por imagen , Sistemas de Atención de Punto , Ultrasonografía/métodos , Adulto , Anciano , Femenino , Mortalidad Hospitalaria , Hospitalización , Humanos , Masculino , Persona de Mediana Edad , Neumonía Viral/mortalidad , Neumonía Viral/virología , Pronóstico , Estudios Prospectivos , /virología , Tiempo de Tratamiento , Tomografía Computarizada por Rayos X
4.
IEEE Trans Ultrason Ferroelectr Freq Control ; 67(11): 2197-2206, 2020 11.
Artículo en Inglés | MEDLINE | ID: covidwho-978670

RESUMEN

Up to April 4, 2020, the novel coronavirus disease-2019 COVID-19 has affected more than 1 099000 patients and has become a major global health concern. World Health Organization (WHO) has defined COVID-19 as a global pandemic. Critical care ultrasound (CCUS) can rapidly acquire the image of lung and other organs and demonstrate the pathophysiological changes to guide precise therapy in COVID-19 pneumonia without radiation or interfering with personal protective equipment. In addition, the application of CCUS can cover the whole courses from the fever clinic to the intensive care unit to improve the treatment. We would like to present the CCUS features about COVID-19 pneumonia and share the application experience of CCUS in Wuhan, China, and hope it works for physicians worldwide to solve the problem and improve the outcome.


Asunto(s)
Infecciones por Coronavirus/diagnóstico por imagen , Cuidados Críticos/métodos , Neumonía Viral/diagnóstico por imagen , Ultrasonografía/métodos , Betacoronavirus , China , Femenino , Humanos , Pulmón/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Pandemias , Posicionamiento del Paciente
5.
IEEE Trans Ultrason Ferroelectr Freq Control ; 67(11): 2230-2240, 2020 11.
Artículo en Inglés | MEDLINE | ID: covidwho-978669

RESUMEN

Since the emergence of the COVID-19 pandemic in December of 2019, clinicians and scientists all over the world have faced overwhelming new challenges that not only threaten their own communities and countries but also the world at large. These challenges have been enormous and debilitating, as the infrastructure of many countries, including developing ones, had little or no resources to deal with the crisis. Even in developed countries, such as Italy, health systems have been so inundated by cases that health care facilities became oversaturated and could not accommodate the unexpected influx of patients to be tested. Initially, resources were focused on testing to identify those who were infected. When it became clear that the virus mainly attacks the lungs by causing parenchymal changes in the form of multifocal pneumonia of different levels of severity, imaging became paramount in the assessment of disease severity, progression, and even response to treatment. As a result, there was a need to establish protocols for imaging of the lungs in these patients. In North America, the focus was on chest X-ray and computed tomography (CT) as these are widely available and accessible at most health facilities. However, in Europe and China, this was not the case, and a cost-effective and relatively fast imaging modality was needed to scan a large number of sick patients promptly. Hence, ultrasound (US) found its way into the hands of Chinese and European physicians and has since become an important imaging modality in those locations. US is a highly versatile, portable, and inexpensive imaging modality that has application across a broad spectrum of conditions and, in this way, is ideally suited to assess the lungs of COVID-19 patients in the intensive care unit (ICU). This bedside test can be done with little to no movement of the patients from the unit that keeps them in their isolated rooms, thereby limiting further exposure to other health personnel. This article presents a basic introduction to COVID-19 and the use of the US for lung imaging. It further provides a high-level overview of the existing US technologies that are driving development in current and potential future US imaging systems for lung, with a specific emphasis on portable and 3-D systems.


Asunto(s)
Infecciones por Coronavirus/diagnóstico por imagen , Neumonía Viral/diagnóstico por imagen , Ultrasonografía/métodos , Betacoronavirus , Comorbilidad , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/patología , Infecciones por Coronavirus/fisiopatología , Humanos , Imagenología Tridimensional , Pulmón/diagnóstico por imagen , Pulmón/patología , Pulmón/fisiopatología , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/patología , Neumonía Viral/fisiopatología
6.
IEEE Trans Ultrason Ferroelectr Freq Control ; 67(11): 2207-2217, 2020 11.
Artículo en Inglés | MEDLINE | ID: covidwho-978667

RESUMEN

Recent works highlighted the significant potential of lung ultrasound (LUS) imaging in the management of subjects affected by COVID-19. In general, the development of objective, fast, and accurate automatic methods for LUS data evaluation is still at an early stage. This is particularly true for COVID-19 diagnostic. In this article, we propose an automatic and unsupervised method for the detection and localization of the pleural line in LUS data based on the hidden Markov model and Viterbi Algorithm. The pleural line localization step is followed by a supervised classification procedure based on the support vector machine (SVM). The classifier evaluates the healthiness level of a patient and, if present, the severity of the pathology, i.e., the score value for each image of a given LUS acquisition. The experiments performed on a variety of LUS data acquired in Italian hospitals with both linear and convex probes highlight the effectiveness of the proposed method. The average overall accuracy in detecting the pleura is 84% and 94% for convex and linear probes, respectively. The accuracy of the SVM classification in correctly evaluating the severity of COVID-19 related pleural line alterations is about 88% and 94% for convex and linear probes, respectively. The results as well as the visualization of the detected pleural line and the predicted score chart, provide a significant support to medical staff for further evaluating the patient condition.


Asunto(s)
Infecciones por Coronavirus/diagnóstico por imagen , Interpretación de Imagen Asistida por Computador/métodos , Pulmón/diagnóstico por imagen , Pleura/diagnóstico por imagen , Neumonía Viral/diagnóstico por imagen , Ultrasonografía/métodos , Algoritmos , Humanos , Pandemias , Procesamiento de Señales Asistido por Computador , Máquina de Vectores de Soporte
8.
IEEE Trans Ultrason Ferroelectr Freq Control ; 67(11): 2218-2229, 2020 11.
Artículo en Inglés | MEDLINE | ID: covidwho-889664

RESUMEN

In this article, we present a novel method for line artifacts quantification in lung ultrasound (LUS) images of COVID-19 patients. We formulate this as a nonconvex regularization problem involving a sparsity-enforcing, Cauchy-based penalty function, and the inverse Radon transform. We employ a simple local maxima detection technique in the Radon transform domain, associated with known clinical definitions of line artifacts. Despite being nonconvex, the proposed technique is guaranteed to convergence through our proposed Cauchy proximal splitting (CPS) method, and accurately identifies both horizontal and vertical line artifacts in LUS images. To reduce the number of false and missed detection, our method includes a two-stage validation mechanism, which is performed in both Radon and image domains. We evaluate the performance of the proposed method in comparison to the current state-of-the-art B-line identification method, and show a considerable performance gain with 87% correctly detected B-lines in LUS images of nine COVID-19 patients.


Asunto(s)
Infecciones por Coronavirus/diagnóstico por imagen , Interpretación de Imagen Asistida por Computador/métodos , Pulmón/diagnóstico por imagen , Neumonía Viral/diagnóstico por imagen , Ultrasonografía/métodos , Anciano , Algoritmos , Artefactos , Betacoronavirus , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Pleura/diagnóstico por imagen , Curva ROC
9.
J Popul Ther Clin Pharmacol ; 27(S Pt 1): e64-e75, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-884097

RESUMEN

The novel coronavirus disease (COVID-19) is a challenge to every health system. Unfortunately, it is unlikely that this pandemic will disappear soon. No health system, with its present resources and workflow, is capable enough to deal with a full-blown wave of this pandemic. Acquisition of specific new skills may be fundamental in delivering appropriate health care for our patients. The gold standard for diagnosis of the COVID-19 infection is real-time reverse transcription polymerase chain reaction. Radiological investigations (chest X-ray or high-resolution computerized tomography [CT]) can be helpful both for diagnosis and management, but they have many limitations. Ultrasound has been suggested as a reliable and accurate tool for assessing the lungs in COVID-19 patients. Lung ultrasound (LUS) can show specific signs of interstitial pneumonia, which is characteristic of COVID-19 pulmonary infection. In addition, nonradiologist specialists with experience in ultrasound can be trained on LUS with a relatively rapid learning curve. In pregnancy, LUS can be particularly useful due to the avoidance of exposure to ionizing radiation. In this review, we present the advantages, techniques, and limitations of the use of LUS during the COVID-19 pandemic, with specific focus on pregnancy.


Asunto(s)
Infecciones por Coronavirus/diagnóstico por imagen , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/patología , Neumonía Viral/diagnóstico por imagen , Neumonía Viral/epidemiología , Neumonía Viral/patología , Ultrasonografía/métodos , Betacoronavirus , Femenino , Humanos , Pulmón/diagnóstico por imagen , Pandemias , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico por imagen , Complicaciones Infecciosas del Embarazo/patología , Reacción en Cadena en Tiempo Real de la Polimerasa , Tomografía Computarizada por Rayos X
10.
Ultrasound Med Biol ; 47(1): 19-24, 2021 01.
Artículo en Inglés | MEDLINE | ID: covidwho-882793

RESUMEN

Ultrasound imaging of the lung (LUS) and associated tissues has demonstrated clinical utility in coronavirus disease 2019 (COVID-19) patients. The aim of the present study was to evaluate the possibilities of a portable pocket-sized ultrasound scanner in the evaluation of lung involvement in patients with COVID-19 pneumonia. We conducted 437 paired readings in 34 LUS evaluations of hospitalized individuals with COVID-19. The LUS scans were performed on the same day with a standard high-end ultrasound scanner (Venue GO, GE Healthcare, Chicago, IL, USA) and a pocket-sized ultrasound scanner (Butterfly iQ, Butterfly Network Inc., Guilford, CT, USA). Fourteen scans were performed on individuals with severe cases, 11 on individuals with moderate cases and nine on individuals with mild cases. No difference was observed between groups in days since onset of symptoms (23.29 ± 10.07, 22.91 ± 8.91 and 28.56 ± 11.13 d, respectively; p = 0.38). No significant differences were found between LUS scores obtained with the high-end and the portable pocket-sized ultrasound scanner. LUS scores in individuals with mild respiratory impairment were significantly lower than in those with moderate and severe cases. Our study confirms the possibilities of portable pocket-sized ultrasound imaging of the lung in COVID-19 patients. Portable pocket-sized ultrasound scanners are cheap, easy to handle and equivalent to standard scanners for non-invasive assessment of severity and dynamic observation of lung lesions in COVID-19 patients.


Asunto(s)
/diagnóstico por imagen , Pulmón/diagnóstico por imagen , Ultrasonografía/instrumentación , Ultrasonografía/métodos , Diseño de Equipo , Humanos , Reproducibilidad de los Resultados , Índice de Severidad de la Enfermedad
11.
Am J Otolaryngol ; 42(1): 102772, 2021.
Artículo en Inglés | MEDLINE | ID: covidwho-880396

RESUMEN

PURPOSE: With the current COVID-19 outbreak, otolaryngologists are most exposed to the risk of infection due to the nature of the specialty.This is why they are required to find safer diagnostic alternatives minimizing aerosol-generating procedures. The aim of this study is to explore the accuracy of transcutaneous laryngeal ultrasonography (TLUSG) in order to assess vocal fold movement. MATERIALS AND METHODS: We performed blindly both TLUSG and flexible fiberoptic laryngoscopy(FFL) on 38 patients, from March to June 2020. Patients were divided into two groups:the former with normally mobile vocal folds and the latter with unilateral vocal fold paralysis. RESULTS: On FFL findings, 10/38 patients (26,31%) had unilateral vocal fold paralysis; on TLUSG results, 9/38 patients (23.68%) presented impaired vocal fold motion. In comparison to laryngoscopy, the sensitivity, specificity, positive predictive value and negative predictive value of TLUSG for assessment of vocal fold mobility was 80%, 96.42%, 88.88%, 93.10% respectively. A significant association between the two techniques was found on the Chi-square test: X2 = 19.7722 (p value <0.00001). Cohen's K value showed a substantial agreement: K = 0,79. CONCLUSION: Although TLUSG could undoubtedly not replace laringoscopy, it represents a noninvasive and useful diagnostic tool for otolaryngologists especially during covid-19 pandemic.Data collected about its high sensitivity and specificity suggest that TLUSG could be a reliable method to screen vocal fold paralysis without performing aerosol-generating procedures, thus providing clear visualization of laryngeal real-time movements, even in non-compliant or high-risk infection patients. Our results allow us to consider TLUSG as part of the preoperative assessment of vocal folds in patients undergoing thyroidectomy.


Asunto(s)
/epidemiología , Enfermedades de la Laringe/diagnóstico , Laringe/diagnóstico por imagen , Otorrinolaringólogos , Pandemias , Ultrasonografía/métodos , Anciano , Comorbilidad , Femenino , Humanos , Enfermedades de la Laringe/epidemiología , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados
12.
J Med Case Rep ; 14(1): 188, 2020 Oct 15.
Artículo en Inglés | MEDLINE | ID: covidwho-863352

RESUMEN

BACKGROUND: Currently, there is minimal data available highlighting the prevalence of venous thromboembolism in patients infected with coronavirus disease 2019 (COVID-19). This case report with a literature review emphasizes a unique presentation of COVID-19 that is highly important for health care providers to consider when treating their patients. CASE REPORT: A 65-year-old Caucasian male patient presented to the emergency department with a 2-day history of dyspnea on exertion after his wife's recent diagnosis of COVID-19. He additionally had experienced a couple of episodes of self-resolving diarrhea a few days before presentation. Based on the patient's clinical presentation and the laboratory workup identifying an elevated D-dimer, a computed tomography angiogram of the chest was obtained, which was significant for moderately large, bilateral pulmonary emboli with a saddle embolus, and an associated small, left lower lobe, pulmonary infarct. Ultrasound of the lower extremity showed non-occlusive deep vein thrombosis at the distal left femoral vein to the left popliteal vein. The patient was additionally diagnosed with COVID-19 when the results of the COVID-19 polymerase chain reaction test returned as positive. The patient was admitted to the COVID unit, and he was started on an intravenously administered, unfractionated heparin drip for management of his bilateral pulmonary emboli and deep vein thrombosis. The patient's clinical condition improved significantly with anticoagulation, and he was observed in the hospital for 3 days, after which he was discharged home on the enoxaparin bridge with warfarin. Post-discharge telephone calls at day 10 and week 4 revealed that the patient was appropriately responding to anticoagulation treatment and had no recurrence of his symptoms related to venous thromboembolism and COVID-19. CONCLUSION: As COVID-19 continues to lead to significant mortality, more data is emerging that is exposing its perplexing pathogenicity. Meanwhile, the presentation of venous thromboembolism in patients with COVID-19 remains an unusual finding. It is imperative for health care providers to be mindful of this unique association to make necessary diagnostic evaluations and provide appropriate treatment for the patients.


Asunto(s)
Infecciones por Coronavirus , Enoxaparina/administración & dosificación , Vena Femoral/diagnóstico por imagen , Heparina/administración & dosificación , Pandemias , Neumonía Viral , Embolia Pulmonar , Tromboembolia Venosa , Warfarina/administración & dosificación , Anciano , Anticoagulantes/administración & dosificación , Betacoronavirus/aislamiento & purificación , Angiografía por Tomografía Computarizada/métodos , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/diagnóstico , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Hospitalización , Humanos , Pulmón/diagnóstico por imagen , Masculino , Neumonía Viral/sangre , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/etiología , Embolia Pulmonar/terapia , Resultado del Tratamiento , Ultrasonografía/métodos , Tromboembolia Venosa/diagnóstico , Tromboembolia Venosa/etiología , Tromboembolia Venosa/terapia
14.
Radiographics ; 40(6): 1574-1599, 2020 10.
Artículo en Inglés | MEDLINE | ID: covidwho-810605

RESUMEN

Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) results in coronavirus disease 2019 (COVID-19), which was declared an official pandemic by the World Health Organization on March 11, 2020. The infection has been reported in most countries around the world. As of August 2020, there have been over 21 million cases of COVID-19 reported worldwide, with over 800 000 COVID-19-associated deaths. It has become apparent that although COVID-19 predominantly affects the respiratory system, many other organ systems can also be involved. Imaging plays an essential role in the diagnosis of all manifestations of the disease, as well as its related complications, and proper utilization and interpretation of imaging examinations is crucial. With the growing global COVID-19 outbreak, a comprehensive understanding of the diagnostic imaging hallmarks, imaging features, multisystemic involvement, and evolution of imaging findings is essential for effective patient management and treatment. To date, only a few articles have been published that comprehensively describe the multisystemic imaging manifestations of COVID-19. The authors provide an inclusive system-by-system image-based review of this life-threatening and rapidly spreading infection. In part 1 of this article, the authors discuss general aspects of the disease, with an emphasis on virology, the pathophysiology of the virus, and clinical presentation of the disease. The key imaging features of the varied pathologic manifestations of this infection that involve the pulmonary and peripheral and central vascular systems are also described. Part 2 will focus on key imaging features of COVID-19 that involve the cardiac, neurologic, abdominal, dermatologic and ocular, and musculoskeletal systems, as well as pediatric and pregnancy-related manifestations of the virus. Vascular complications pertinent to each system will be also be discussed in part 2. Online supplemental material is available for this article. ©RSNA, 2020.


Asunto(s)
Betacoronavirus/fisiología , Infecciones por Coronavirus/diagnóstico por imagen , Pulmón/diagnóstico por imagen , Pandemias , Neumonía Viral/diagnóstico por imagen , Tromboembolia/diagnóstico por imagen , Trombosis/diagnóstico por imagen , Angiografía/métodos , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Síndrome de Liberación de Citoquinas/etiología , Síndrome de Liberación de Citoquinas/fisiopatología , Progresión de la Enfermedad , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Humanos , Inflamación , Peptidil-Dipeptidasa A/fisiología , Neumonía Viral/complicaciones , Neumonía Viral/epidemiología , Neumonía Viral/virología , Arteria Pulmonar/diagnóstico por imagen , Receptores Virales/fisiología , /etiología , Evaluación de Síntomas , Tromboembolia/sangre , Tromboembolia/etiología , Trombosis/sangre , Trombosis/etiología , Microangiopatías Trombóticas/diagnóstico por imagen , Microangiopatías Trombóticas/etiología , Tomografía Computarizada por Rayos X/métodos , Ultrasonografía/métodos
17.
Pediatr Emerg Care ; 36(11): 544-548, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: covidwho-760069

RESUMEN

Lung point-of-care ultrasound (POCUS) has been shown to be useful for identifying pulmonary pathology in adult patients with coronavirus disease 2019 (COVID-19). However, pediatric literature for POCUS in COVID-19 is limited. The objective of this case series was to describe lung POCUS findings in pediatric patients with COVID-19. Three patients with COVID-19 who had lung POCUS performed in a pediatric emergency department were included. Point-of-care ultrasound revealed bilateral abnormalities in all patients, including pleural line irregularities, scattered and coalescing B-lines, consolidations, and pleural effusions. Additional pediatric studies are necessary to gain a broader understanding of COVID-19's sonographic appearance in this age group and to determine whether POCUS may be helpful to facilitate diagnosis and expedite management decisions.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/diagnóstico , Servicio de Urgencia en Hospital , Pulmón/diagnóstico por imagen , Pandemias , Neumonía Viral/diagnóstico , Sistemas de Atención de Punto , Ultrasonografía/métodos , Niño , Infecciones por Coronavirus/epidemiología , Femenino , Humanos , Masculino , Neumonía Viral/epidemiología , Adulto Joven
18.
Infez Med ; 28(3): 346-350, 2020 Sep 01.
Artículo en Inglés | MEDLINE | ID: covidwho-757686

RESUMEN

Ultra-High-Resolution Computed Tomography (U-HR-CT) is the reference imaging technique for pneumonia in the new coronavirus disease (COVID-19). Pulmonary Ultrasound (LUS) could be a valid diagnostic alternative for the imaging of COVID-19. Our study aimed to investigate the clinical performance of LUS in the initial evaluation of pneumonia in COVID-19 patients, compared to standard U-HR-CT. Among 29 patients with confirmed COVID-19, all U-HR-CT hallmarks showed an excellent concordance with LUS findings according to Cohen coefficient. In our experience, LUS is a viable alternative to U-HR-CT, with the advantages of being radiation-free, flexible, cost-effective, and reasonably reducing nosocomial transmission risks because performed at bed-side.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/diagnóstico por imagen , Pulmón/diagnóstico por imagen , Neumonía Viral/diagnóstico por imagen , Ultrasonografía/métodos , Adulto , Anciano , Femenino , Humanos , Italia , Masculino , Persona de Mediana Edad , Pandemias , Estudios Prospectivos , Reacción en Cadena en Tiempo Real de la Polimerasa , Tomografía Computarizada por Rayos X/métodos
20.
Expert Rev Mol Diagn ; 20(9): 971-983, 2020 09.
Artículo en Inglés | MEDLINE | ID: covidwho-748285

RESUMEN

INTRODUCTION: The starting months of 2020 witnessed a global pandemic of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection. The first case of Coronavirus Disease 2019 (COVID-19) was reported in December, 2019 in Wuhan, China and millions of cases and thousands of deaths were reported within five months. Currently, reverse transcription-polymerase chain reaction (RT-PCR) and computed tomography (CT) scanning are clinically prescribed for COVID-19 detection across the globe. AREAS COVERED: This systematic review is focused on currently used diagnostic methods for COVID-19 detection and their future prospects. Online searches on Google Scholar, PubMed and online resources were conducted on the period of year 2017 to mid-2020. Studies investigating laboratory examinations, radiographical analysis, and potential sensors for COVID-19 detection were included. Along with this, the current status of commercially available kits for SARS-CoV-2 coronavirus detection is discussed. EXPERT OPINION: The search has identified the potential applications of nucleic acid technology, diagnostics radiology examinations, and in-vitro diagnostic kits in detection of COVID-19 infections. Despite having their own limitations of each technology, the emerging diagnostic technologies for COVID-19 detection along with undergoing clinical trials are summarized suggesting more collaborations and funding are required for fast track clinical trials.


Asunto(s)
Betacoronavirus/genética , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico , Neumonía Viral/diagnóstico , Técnicas Biosensibles , Sistemas CRISPR-Cas , Infecciones por Coronavirus/diagnóstico por imagen , Testimonio de Experto , Humanos , Pandemias , Juego de Reactivos para Diagnóstico , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa/métodos , Tomografía Computarizada por Rayos X/métodos , Ultrasonografía/métodos
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