Point-of-care lung ultrasound assessment for risk stratification and therapy guiding in COVID-19 patients. A prospective non-interventional study.
Rubio-Gracia, Jorge (Universidad de Zaragoza) ; Giménez-López, Ignacio (Universidad de Zaragoza) ; Garcés-Horna, Vanessa (Universidad de Zaragoza) ; López-Delgado, Daniel ; Sierra-Monzón, José Luis ; Martínez-Lostao, Luis (Universidad de Zaragoza) ; Josa-Laorden, Claudia (Universidad de Zaragoza) ; Ruiz-Laiglesia, Fernando (Universidad de Zaragoza) ; Pérez-Calvo, Juan Ignacio (Universidad de Zaragoza) ; Crespo-Aznarez, Silvia ; García-Lafuente, J. ; Peña Fresneda, Natacha ; Amores Arriaga, Beatriz (Universidad de Zaragoza) ; Gracia-Tello, Borja ; Sánchez-Marteles, Marta (Universidad de Zaragoza)
Resumen: Background 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.
Methods 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.
Results 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.
Conclusions 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.
Idioma: Inglés
DOI: 10.1183/13993003.04283-2020
Año: 2021
Publicado en: European respiratory journal 58, 3 (2021), 2004283 [9 pp.]
ISSN: 0903-1936
Factor impacto JCR: 33.801 (2021)
Categ. JCR: RESPIRATORY SYSTEM rank: 2 / 66 = 0.03 (2021) - Q1 - T1
Factor impacto CITESCORE: 18.9 - Medicine (Q1)
Factor impacto SCIMAGO: 4.336 - Pulmonary and Respiratory Medicine (Q1) - Medicine (miscellaneous) (Q1)
Tipo y forma: Article (Published version)
Área (Departamento): Área Fisiología (Dpto. Farmac.Fisiol.y Med.L.F.)
Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)
Área (Departamento): Área Inmunología (Dpto. Microb.Ped.Radio.Sal.Pú.)
You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. You may not use the material for commercial purposes.
Exportado de SIDERAL (2023-10-27-12:53:53)
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Methods 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.
Results 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.
Conclusions 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.
Idioma: Inglés
DOI: 10.1183/13993003.04283-2020
Año: 2021
Publicado en: European respiratory journal 58, 3 (2021), 2004283 [9 pp.]
ISSN: 0903-1936
Factor impacto JCR: 33.801 (2021)
Categ. JCR: RESPIRATORY SYSTEM rank: 2 / 66 = 0.03 (2021) - Q1 - T1
Factor impacto CITESCORE: 18.9 - Medicine (Q1)
Factor impacto SCIMAGO: 4.336 - Pulmonary and Respiratory Medicine (Q1) - Medicine (miscellaneous) (Q1)
Tipo y forma: Article (Published version)
Área (Departamento): Área Fisiología (Dpto. Farmac.Fisiol.y Med.L.F.)
Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)
Área (Departamento): Área Inmunología (Dpto. Microb.Ped.Radio.Sal.Pú.)
You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. You may not use the material for commercial purposes. Exportado de SIDERAL (2023-10-27-12:53:53)
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Record created 2021-12-01, last modified 2023-10-27