Point-of-care lung ultrasound assessment for risk stratification and therapy guiding in COVID-19 patients: a prospective noninterventional study.
Point-of-care lung ultrasound assessment for risk stratification and therapy guiding in COVID-19 patients: a prospective noninterventional study.
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DOI：
10.1183/13993003.04283-2020
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发表时间：
2021-09
期刊：
影响因子：
--
通讯作者：
Sánchez-Marteles M
中科院分区：
文献类型：
--
作者：
Rubio-Gracia J;Giménez-López I;Garcés-Horna V;López-Delgado D;Sierra-Monzón JL;Martínez-Lostao L;Josa-Laorden C;Ruiz-Laiglesia F;Pérez-Calvo JI;Crespo-Aznarez S;García-Lafuente J;Peña Fresneda N;Amores Arriaga B;Gracia-Tello B;Sánchez-Marteles M
肺部超声可用于评估2019冠状病毒病（COVID-19）所致肺损伤。然而，在COVID-19住院患者中，肺部超声评估肺损伤的预后意义和时间线变化尚不清楚。前瞻性队列研究旨在通过定量量表（肺超声萨拉戈萨（LUZ）评分）分析COVID-19患者入院后最初72 h肺部超声的预后价值。主要终点为院内死亡和/或入住重症监护病房。前72小时的总住院时间、氧流量增加和医疗升级是次要终点。130例患者纳入最终分析；平均±sd年龄为56.7±13.5岁。从症状开始到入院的中位时间（四分位数范围）为6（4-9）天。在入院前72小时内，luz评分评估的肺损伤没有差异(入院时为21（16-26）分，入院时为20（16-27）分；p = 0.183)。在单变量logistic回归分析中，估计动脉氧张力/吸气氧分数比（PAFI）（风险比0.99,95% CI 0.98-0.99; p=0.027）和luz评分bbb22分（5.45,1.42-20.90;p=0.013）是主要终点的预测因子。LUZ-score是一种方便、简单、快速的即时超声工具，可在入院时识别COVID-19所致严重肺损伤患者。基线评分可预测整个住院期间的严重程度。该评分有助于及早实施或加强COVID-19感染的治疗。luz评分可与临床变量（根据PAFI估计）相结合，进一步细化风险分层。2019冠状病毒病（COVID-19）引起的肺损伤可以通过肺部超声测量。肺部超声可识别并发症风险较高的COVID-19患者，并可支持COVID-19患者的临床决策。http://bit.ly/3cQiz6K
Lung ultrasound is feasible for assessing lung injury caused by coronavirus disease 2019 (COVID-19). However, the prognostic meaning and time-line changes of lung injury assessed by lung ultrasound in COVID-19 hospitalised patients are unknown. Prospective cohort study designed to analyse prognostic value of lung ultrasound in COVID-19 patients by using a quantitative scale (lung ultrasound Zaragoza (LUZ)-score) during the first 72 h after admission. The primary end-point was in-hospital death and/or admission to the intensive care unit. Total length of hospital stay, increase of oxygen flow and escalation of medical treatment during the first 72 h were secondary end-points. 130 patients were included in the final analysis; mean±sd age was 56.7±13.5 years. Median (interquartile range) time from the beginning of symptoms to admission was 6 (4–9) days. Lung injury assessed by LUZ-score did not differ during the first 72 h (21 (16–26) points at admission versus 20 (16–27) points at 72 h; p=0.183). In univariable logistic regression analysis, estimated arterial oxygen tension/inspiratory oxygen fraction ratio (PAFI) (hazard ratio 0.99, 95% CI 0.98–0.99; p=0.027) and LUZ-score >22 points (5.45, 1.42–20.90; p=0.013) were predictors for the primary end-point. LUZ-score is an easy, simple and fast point-of-care ultrasound tool to identify patients with severe lung injury due to COVID-19, upon admission. Baseline score is predictive of severity along the whole period of hospitalisation. The score facilitates early implementation or intensification of treatment for COVID-19 infection. LUZ-score may be combined with clinical variables (as estimated by PAFI) to further refine risk stratification. Lung injury caused by coronavirus disease 2019 (COVID-19) can be measured through lung ultrasound. Lung ultrasound identifies COVID-19 patients at a higher risk of complications, and could support clinical-decision making in COVID-19 patients. http://bit.ly/3cQiz6K
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