[Assessment of the effectiveness and predictive value of lung ultrasound in the COVID-19 diagnostic process and its correlation with computed tomography]. / Ocena skutecznosci oraz wartosci predykcyjnej ultrasonografii pluc w procesie diagnostycznym COVID-19 oraz korelacji tego badania z tomografia komputerowa.

The spreading pandemic, successive waves and increasingly inefficient hospital care system contributed to the analysis and inclusion of lung ultrasonography (LUS) in the COVID-19 diagnostic process, which is faster, cheaper, more available and safer method for patients. It is also the method of choice for pregnant women and children. AIM: The aim of this study was to analyze the effectiveness of lung ultrasound in the diagnostic process, its predictive value and its comparison with computed tomography (CT) of the chest. MATERIALS AND METHODS: A literature review was conducted with keyword in the title and abstracts in the Pubmed National Library of Medicine database. RESULTS: Twenty papers were reviewed which showed a high consistency in CT and ultrasound image evaluation, particularly in the inferolateral and posterior lung areas. The association between LUS and CT images with disease severity has also been demonstrated, which translates into the predictive value of these studies related to hospitalization, use of invasive and non-invasive mechanical ventilation, and mortality in COVID-19 patients. An association between the stage of disease severity assessed by LUS and elevated levels of inflammatory markers were revealed. In addition, lung ultrasound showed high sensitivity in the early stages of the disease. CONCLUSIONS: Ultrasound performed by appropriately trained staff is a good diagnostic and prognostic tool in the Hospital Emergency Department and Intensive Care Unit. Nevertheless, due to the subjectivity and technical limitations of this study, this method needs further research.

[Ocular symptoms in SARS-CoV-2 infection]. / Objawy oczne w zakazeniu SARS-CoV-2.

The first cases of COVID-19 were reported in Wuhan city, Hubei province, China. Patients reported symptoms such as dry cough, dyspnea, fever. Bilateral infiltrates in the lung parenchyma could be seen in imaging studies. Two years after the diagnosis of the first case of COVID-19, we are confident that symptoms manifest in every organ, including the eyes. Ocular manifestations may result from the COVID- 19 infection itself as well as from associated treatment, including mechanical ventilation or drug therapy. Ocular manifestations may be the first signs of COVID-19, so this knowledge is essential for making a prompt and correct diagnosis. It is important to be aware of the risks associated with the possibility of infection during the ophthalmic examination of these patients. AIM: The aim of the analysis was to perform a literature review systematizing the knowledge on ocular manifestations in the course of the COVID-19 infection with particular emphasis on the relation between the occurrence of ocular symptoms and the age of patients as well as the severity of the COVID-19 course. The review also included studies that evaluated the detection of the SARS-CoV-2 virus in tears or conjunctival sac swabs of patients with COVID-19. MATERIALS AND METHODS: Articles for the literature review were collected from the PubMed database. The expression "COVID-19 ocular manifestations" was used as the selection criteria. Finally, fifteen papers published in 2020 and fifteen papers published in 2021 were included in the review. Nineteen of these were original papers, two were meta-analyses, and nine were classified as review papers. RESULTS: The most commonly reported ocular manifestations include dry eye or foreign body sensation, conjunctival hyperaemia, tearing, itching, and eye pain. Conjunctivitis was the most commonly diagnosed ophthalmic disease among COVID-19 patients. The SARS-CoV-2 infection is also associated with a risk of a significant decrease in visual acuity due to retinal vascular occlusion, ischemic optic neuropathy, inflammation of the choroid, retina and the optic nerve. The incidence of the most common ocular surface-related symptoms was higher in children than in adults. In several studies it has been shown that patients with more severe COVID-19 infection are more likely to have ocular symptoms. CONCLUSIONS: Physicians, especially ophthalmologists, should be aware of the link between SARS-CoV-2 infection and the possibility of ocular symptoms and should recommend testing for COVID-19 if SARS-CoV-2 infection is suspected to reduce the possibility of infection spread.