Lung ultrasound as diagnostic tool for SARS-CoV-2 infection.

Lung ultrasound as diagnostic tool for SARS-CoV-2 infection.
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肺部超声作为SARS-CoV-2感染的诊断工具

DOI:
10.1007/s11739-020-02512-y
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发表时间:
2021-03
影响因子:
4.6
通讯作者:
Numis FG
Numis FG
中科院分区:
医学3区
文献类型:
--
作者:
Bosso G;Allegorico E;Pagano A;Porta G;Serra C;Minerva V;Mercurio V;Russo T;Altruda C;Arbo P;De Sio C;Dello Vicario F;Numis FG

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本研究的目的是探讨肺超声(LUS)在诊断SARS-CoV-2感染中的作用,并验证其在预测肺部疾病严重程度和预后方面的实用性。在圣玛丽亚·德尔·格拉济医院急诊科连续就诊的53名高度怀疑SARS-CoV-2感染的患者对鼻咽拭子样本进行了SARS-CoV-2诊断检测,并进行了完整的适当诊断检查,包括临床评估、实验室检查、血气分析、胸部CT和LUS。对b系分布进行半定量分析,计算LUS评分。根据SARS-CoV-2诊断试验和其他检查结果将患者分为两组(A组= SARS-CoV2感染所致肺炎,B组=未感染SARS-CoV2并有明确诊断)。LUS在预测SARS-CoV-2感染诊断方面表现出极好的准确性(ROC曲线下面积为0.92,敏感性为73%,特异性为89%,截止值为12.5)。SARS-CoV-2患者LUS评分受损更严重(18.1±6.0 vs 7.6±5.9,p < 0.00001),且与PF比值值呈显著负相关(r = - 0.719, p < 0.0001)。发现院内死亡率为46%;不良结局患者的LUS、PF、LDH、APACHEⅱ评分值显著增高。这些参数都不能预测死亡率。LUS是早期发现SARS-CoV-2感染和评估疾病严重程度的有用工具,但不能预测死亡率。为了进一步探讨LUS在SARS-CoV-2疾病严重程度评估和治疗反应监测中的作用,需要进一步开展重复评估LUS评分的研究。
The aim of this study was to explore the role of lung ultrasound (LUS) in the diagnosis of SARS-CoV-2 infection and to verify its utility in the prediction of lung disease’s severity and outcome. Fifty-three consecutive patients presenting to the Emergency Department of Santa Maria delle Grazie Hospital with high suspicion of SARS-CoV-2 infection underwent diagnostic test for SARS-CoV-2 on samples obtained from nasopharyngeal swab as well as complete proper diagnostic work-up that included clinical evaluation, laboratory tests, blood gas analyses, chest CT and LUS. A semiquantitative analysis of B-lines distribution was performed to calculate the LUS score. Patients were divided into two groups according to the results of both SARS-CoV-2 diagnostic test and other exams (Group A = pneumonia due to SARS-CoV2 infection vs Group B = no SARS-CoV2 infection and another definite diagnosis). LUS showed an excellent accuracy in predicting the diagnosis of SARS-CoV-2 infection (area under the ROC curve of 0.92 with a sensibility of 73% and a specificity of 89% a the cut-off of 12.5). LUS score was more impaired in SARS-CoV-2 patients (18.1 ± 6.0 vs 7.6 ± 5.9, p < 0.00001) and it is significantly negatively correlated with PF ratio values (r = − 0.719, p < 0.0001). An intrahospital mortality rate of 46% was found; patients with adverse outcome had significant higher value of LUS, PF, LDH, and APACHE II score. None of these parameters was predictive of mortality. LUS is a useful tool for the early detection of SARS-CoV-2 infection and for the evaluation of the disease severity, but does not predict mortality. Further studies with repeated evaluations of LUS score are needed to further explore the role of LUS in the assessment of severity in SARS-CoV-2 disease and in the monitoring of the response to treatments.
DOI: 10.1007/s40477-020-00458-7
发表时间: 2020-04-16
影响因子: 2
作者:
Sofia, Soccorsa;Boccatonda, Andrea;Schiavone, Cosima
通讯作者: Schiavone, Cosima
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发表时间: 2016-08-13
期刊: Critical care (London, England)
影响因子: --
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Vincent JL;Quintairos E Silva A;Couto L Jr;Taccone FS
通讯作者: Taccone FS
DOI: 10.1097/rli.0000000000000672
发表时间: 2020-06-01
影响因子: 6.7
作者:
Li, Kunhua;Wu, Jiong;Li, Chuanming
通讯作者: Li, Chuanming
DOI: 10.1097/ccm.0000000000003340
发表时间: 2018-11-01
影响因子: 8.8
作者:
Chiumello, Davide;Mongodi, Silvia;Mojoli, Francesco
通讯作者: Mojoli, Francesco
DOI: 10.26355/eurrev_202004_20875
发表时间: 2020-04-01
影响因子: 3.3
作者:
Diurno, F.;Numis, F. G.;Facchini, G.
通讯作者: Facchini, G.