LUNG ULTRASOUND FINDINGS ARE ASSOCIATED WITH MORTALITY AND NEED FOR INTENSIVE CARE ADMISSION IN COVID-19 PATIENTS EVALUATED IN THE EMERGENCY DEPARTMENT
LUNG ULTRASOUND FINDINGS ARE ASSOCIATED WITH MORTALITY AND NEED FOR INTENSIVE CARE ADMISSION IN COVID-19 PATIENTS EVALUATED IN THE EMERGENCY DEPARTMENT
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DOI：
10.1016/j.ultrasmedbio.2020.07.005
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发表时间：
2020-11-01
影响因子：
2.9
通讯作者：
Franceschi, Francesco
中科院分区：
文献类型：
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作者：
Bonadia, Nicola;Carnicelli, Annamaria;Franceschi, Francesco
最近，肺部超声（LUS）被认为是诊断新型冠状病毒肺炎（COVID-19）的准确工具。然而，关于其使用的报道主要基于假设研究、病例报告或小型回顾性病例系列，而LUS在COVID-19患者中的预后作用尚未确定。我们进行了一项前瞻性研究，旨在评估LUS预测三级急诊科评估的COVID-19患者死亡率和重症监护病房入住的能力。我们样本中的患者中位数为6个肺区有病理发现（四分位数间距[IQR]: 6，范围：0-14），定义为评分不同于0。肺面积受累率中位数为71% (IQR: 64%，范围0-100)，平均评分中位数为1.14 （IQR: 0.93，范围0-3）。较高的病理性肺面积率和较高的平均评分与死亡显著相关，估计差异分别为40.5%（95%可信区间[CI]: 4%-68%， p = 0.01）和0.47 （95% CI: 0.06-0.93, p = 0.02）。同样，相同的参数与入住重症监护病房的风险显著升高相关，估计差异分别为29% （95% CI: 8%-50%, p = 0.008）和0.47 （95% CI: 0.05-0.93, p = 0.02）。我们的研究表明，LUS能够发现COVID-19肺炎，并在急诊科的第一次评估中预测患者进入重症监护病房和死亡的风险。（E-mail: nicola.bonadia@policlinicogemelli.it） (C) 2020世界超声医学与生物学联合会。版权所有。
Lung ultrasound (LUS) has recently been advocated as an accurate tool to diagnose coronavirus disease 2019 (COVID-19) pneumonia. However, reports on its use are based mainly on hypothesis studies, case reports or small retrospective case series, while the prognostic role of LUS in COVID-19 patients has not yet been established. We conducted a prospective study aimed at assessing the ability of LUS to predict mortality and intensive care unit admission of COVID-19 patients evaluated in a tertiary level emergency department. Patients in our sample had a median of 6 lung areas with pathologic findings (inter-quartile range [IQR]: 6, range: 0-14), defined as a score different from 0. The median rate of lung areas involved was 71% (IQR: 64%, range: 0-100), while the median average score was 1.14 (IQR: 0.93, range: 0-3). A higher rate of pathologic lung areas and a higher average score were significantly associated with death, with an estimated difference of 40.5% (95% confidence interval [CI]: 4%-68%, p = 0.01) and of 0.47 (95% CI: 0.06-0.93, p = 0.02), respectively. Similarly, the same parameters were associated with a significantly higher risk of intensive care unit admission with estimated differences of 29% (95% CI: 8%-50%, p = 0.008) and 0.47 (95% CI: 0.05-0.93, p = 0.02), respectively. Our study indicates that LUS is able to detect COVID-19 pneumonia and to predict, during the first evaluation in the emergency department, patients at risk for intensive care unit admission and death. (E-mail: nicola.bonadia@policlinicogemelli.it) (C) 2020 World Federation for Ultrasound in Medicine & Biology. All rights reserved.