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Point-of-care Lung Ultrasound, Lung CT and NEWS to Predict Adverse Outcomes and Mortality in COVID-19 Associated Pneumonia.
Bardakci, Okan; Das, Murat; Akdur, Gökhan; Akman, Canan; Siddikoglu, Duygu; Simsek, Güven; Kaya, Feyyaz; Atalay, Ünzile; Topal, M Taha; Beyazit, Fatma; Ünal Çetin, Ece; Akdur, Okhan; Beyazit, Yavuz.
  • Bardakci O; Department of Emergency Medicine, Faculty of Medicine, 485518Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
  • Das M; Department of Emergency Medicine, Faculty of Medicine, 485518Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
  • Akdur G; Department of Emergency Medicine, Faculty of Medicine, 485518Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
  • Akman C; Department of Emergency Medicine, Faculty of Medicine, 485518Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
  • Siddikoglu D; Department of Biostatistics, Faculty of Medicine, 485518Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
  • Simsek G; Department of Emergency Medicine, Faculty of Medicine, 485518Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
  • Kaya F; Department of Emergency Medicine, Faculty of Medicine, 485518Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
  • Atalay Ü; Department of Emergency Medicine, Faculty of Medicine, 485518Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
  • Topal MT; Department of Emergency Medicine, Faculty of Medicine, 485518Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
  • Beyazit F; Department of Obstetrics and Gynecology, Faculty of Medicine, 485518Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
  • Ünal Çetin E; Department of Internal Medicine, Faculty of Medicine, 485518Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
  • Akdur O; Department of Emergency Medicine, Faculty of Medicine, 485518Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
  • Beyazit Y; Department of Internal Medicine, Faculty of Medicine, 485518Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
J Intensive Care Med ; 37(12): 1614-1624, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2098205
ABSTRACT

Introduction:

The appraisal of disease severity and prediction of adverse outcomes using risk stratification tools at early disease stages is crucial to diminish mortality from coronavirus disease 2019 (COVID-19). While lung ultrasound (LUS) as an imaging technique for the diagnosis of lung diseases has recently gained a leading position, data demonstrating that it can predict adverse outcomes related to COVID-19 is scarce. The main aim of this study is therefore to assess the clinical significance of bedside LUS in COVID-19 patients who presented to the emergency department (ED).

Methods:

Patients with a confirmed diagnosis of SARS-CoV-2 pneumonia admitted to the ED of our hospital between March 2021 and May 2021 and who underwent a 12-zone LUS and a lung computed tomography scan were included prospectively. Logistic regression and Cox proportional hazard models were used to predict adverse events, which was our primary outcome. The secondary outcome was to discover the association of LUS score and computed tomography severity score (CT-SS) with the composite endpoints.

Results:

We assessed 234 patients [median age 59.0 (46.8-68.0) years; 59.4% M), including 38 (16.2%) in-hospital deaths for any cause related to COVID-19. Higher LUS score and CT-SS was found to be associated with ICU admission, intubation, and mortality. The LUS score predicted mortality risk within each stratum of NEWS. Pairwise analysis demonstrated that after adjusting a base prediction model with LUS score, significantly higher accuracy was observed in predicting both ICU admission (DBA -0.067, P = .011) and in-hospital mortality (DBA -0.086, P = .017).

Conclusion:

Lung ultrasound can be a practical prediction tool during the course of COVID-19 and can quantify pulmonary involvement in ED settings. It is a powerful predictor of ICU admission, intubation, and mortality and can be used as an alternative for chest computed tomography while monitoring COVID-19-related adverse outcomes.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Prognostic study Topics: Long Covid Limits: Humans / Middle aged Language: English Journal: J Intensive Care Med Journal subject: Critical Care Year: 2022 Document Type: Article Affiliation country: 08850666221111731

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Prognostic study Topics: Long Covid Limits: Humans / Middle aged Language: English Journal: J Intensive Care Med Journal subject: Critical Care Year: 2022 Document Type: Article Affiliation country: 08850666221111731