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Summary
Ultrasound findings in acute respiratory disease
Luis Campos Caubet1, Ricardo Campo Linares2, Manuel Ferreiro Gómez3, Joaquín Antonio Álvarez Gregori4, Iván García Suárez5, Juan José Zafra Sánchez6, Ramón Nogué Bou7, Jaldún Chenayeb8
Affiliation of the authors
1Servicio de Urgencias, Hospital Comarcal Sierrallana, Torrelavega, Cantabria, Spain. 2Servicio de Urgencias, Hospital Santa Bárbara, Soria, Spain. 3Servicio de Urgencias, Hospital de A Coruña, La Coruña, Spain. 4Servicio de Urgencias, Hospital General Universitario Nuestra Señora del Prado, Talavera de la Reina, Toledo, Spain. 5Servicio de Urgencias, Hospital San Agustín, Avilés, Spain. 6Servicio de Urgencias, Hospital San Eloy, Bilbao, Spain. 7Servicio de Urgencias, Hospital Santa María, Spain. 8Servicio de Urgencias Hospital Clínico de Valladolid, Valladolid, Spain.
DOI
Quote
Campos Caubet L, Campo Linares R, Ferreiro Gómez M, Álvarez Gregori JA, García Suárez I, Nogué Bou R,. Ultrasound findings in acute respiratory disease. Rev Esp Urg Emerg. 2023;2:78–84
Summary
OBJECTIVES. To assess the value of emergency department use of lung ultrasound imaging to predict prognosis in COVID-19 diagnosed by rapid antigen or polymerase chain reaction testing in in relation to predicting changes in clinical variables reflecting severity: intensive care unit (ICU) admission, need for invasive mechanical ventilation (MV), or noninvasive MV, death, or hospital stay of more than 14 days.
MATERIAL AND METHODS. Prospective observational multicenter study recruiting patients during 3 months in 2020 (April 1 to July 1).
RESULTS. Data for 400 patients were analyzed; 226 were men (56.5%, the mean age was 62.3 years (95% CI, 60.1-64.4 years, and 263 patients (70.8%; 95% CI, 66.1%-75%) had positive test results for COVID-19. The clinical course of 93 of these patients (32.9%; 95% CI, 27.7%-38.5%) resulted in serious illness (ICU admission, invasive or noninvasive MV, death, or hospital stay over 14 days). Abnormal lung ultrasound findings correlated with severity. A noteworthy ultrasound finding was of anterior confluent B-lines, which increased the probability of disease progression 9-fold (odds ratio, 9.41; 95% CI, 4.71-18.78), as well as the likelihood of seeing the clinical outcomes studied. Six of the clinical outcome associations were significant.
CONCLUSIONS. A lung ultrasound score is a good predictor of severity, but it should be used in conjunction with clinical variablesand physical examination. In lung disease in the context of COVID-19, the ultrasound score correlates significantly with clinical variables whose complex associations we were able to simplify in a QR (quick response) code for use in emergency departments.
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