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  1. Article ; Online: Correlation between lung ultrasound and chest CT patterns with estimation of pulmonary burden in COVID-19 patients.

    Rizzetto, Francesco / Perillo, Noemi / Artioli, Diana / Travaglini, Francesca / Cuccia, Alessandra / Zannoni, Stefania / Tombini, Valeria / Di Domenico, Sandro Luigi / Albertini, Valentina / Bergamaschi, Marta / Cazzaniga, Michela / De Mattia, Cristina / Torresin, Alberto / Vanzulli, Angelo

    European journal of radiology

    2021  Volume 138, Page(s) 109650

    Abstract: Purpose: The capability of lung ultrasound (LUS) to distinguish the different pulmonary patterns of COVID-19 and quantify the disease burden compared to chest CT is still unclear.: Methods: PCR-confirmed COVID-19 patients who underwent both LUS and ... ...

    Abstract Purpose: The capability of lung ultrasound (LUS) to distinguish the different pulmonary patterns of COVID-19 and quantify the disease burden compared to chest CT is still unclear.
    Methods: PCR-confirmed COVID-19 patients who underwent both LUS and chest CT at the Emergency Department were retrospectively analysed. In both modalities, twelve peripheral lung zones were identified and given a Severity Score basing on main lesion pattern. On CT scans the well-aerated lung volume (%WALV) was visually estimated. Per-patient and per-zone assessments of LUS classification performance taking CT findings as reference were performed, further revisioning the images in case of discordant results. Correlations between number of disease-positive lung zones, Severity Score and %WALV on both LUS and CT were assessed. The area under receiver operating characteristic curve (AUC) was calculated to determine LUS performance in detecting %WALV ≤ 70 %.
    Results: The study included 219 COVID-19 patients with abnormal chest CT. LUS correctly identified as positive 217 (99 %) patients, but per-zone analysis showed sensitivity = 75 % and specificity = 66 %. The revision of the 121 (55 %) cases with positive LUS and negative CT revealed COVID-compatible lesions in 42 (38 %) CT scans. Number of disease-positive zones, Severity Score and %WALV between LUS and CT showed moderate correlations. The AUCs for LUS Severity Score and number of LUS-positive zones did not differ in detecting %WALV ≤ 70 %.
    Conclusion: LUS in COVID-19 is valuable for case identification but shows only moderate correlation with CT findings as for lesion patterns and severity quantification. The number of disease-positive lung zones in LUS alone was sufficient to discriminate relevant disease burden.
    MeSH term(s) COVID-19 ; Humans ; Lung/diagnostic imaging ; Retrospective Studies ; SARS-CoV-2 ; Tomography, X-Ray Computed ; Ultrasonography
    Language English
    Publishing date 2021-03-11
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 138815-0
    ISSN 1872-7727 ; 0720-048X
    ISSN (online) 1872-7727
    ISSN 0720-048X
    DOI 10.1016/j.ejrad.2021.109650
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Clinical characteristics and respiratory support of 310 COVID-19 patients, diagnosed at the emergency room: a single-center retrospective study.

    Di Domenico, Sandro Luigi / Coen, Daniele / Bergamaschi, Marta / Albertini, Valentina / Ghezzi, Leonardo / Cazzaniga, Michela Maria / Tombini, Valeria / Colombo, Riccardo / Capsoni, Nicolò / Coen, Tommaso / Cazzola, Katia Barbara / Di Fiore, Marina / Angaroni, Laura / Strozzi, Marco Alberto

    Internal and emergency medicine

    2020  Volume 16, Issue 4, Page(s) 1051–1060

    Abstract: An ongoing outbreak of pneumonia associated with severe acute respiratory coronavirus 2 (SARS-CoV-2) occurred at the end of February 2020 in Lombardy, Italy. We analyzed data from a retrospective, single-center case series of 310 consecutive patients, ... ...

    Abstract An ongoing outbreak of pneumonia associated with severe acute respiratory coronavirus 2 (SARS-CoV-2) occurred at the end of February 2020 in Lombardy, Italy. We analyzed data from a retrospective, single-center case series of 310 consecutive patients, with confirmed SARS-CoV-2 infection, admitted to the emergency room. We aimed to describe the clinical course, treatment and outcome of a cohort of patients with COVID-19 pneumonia, with special attention to oxygen delivery and ventilator support. Throughout the study period, 310 consecutive patients, with confirmed SARS-CoV-2 infection, attended the Emergency Room (ER), of these, 34 were discharged home directly from the ER. Of the remaining 276 patients, the overall mortality was 30.4%: 7 patients died in the ER and 77 during hospitalization. With respect to oxygen delivery: 22 patients did not need any oxygen support (8.0%), 151 patients were treated with oxygen only (54.7%), and 49 (17.8%) were intubated. 90 patients (32.6%) were treated with CPAP (Continuous Positive Airway Pressure) or NIV (Non Invasive Ventilation); in this group, 27 patients had a Do Not Intubate (DNI) order and were treated with CPAP/NIV as an upper threshold therapy, showing high mortality rate (88.9%). Among the 63 patients treated with CPAP/NIV without DNI, NIV failure occurred in 36 patients (57.1%), with mortality rate of 47.2%. Twenty-seven (27) patients were treated with CPAP/NIV without needing mechanical ventilation and 26 were discharged alive (96.3%). The study documents the poor prognosis of patients with severe respiratory failure, although a considerable minority of patients treated with CPAP/NIV had a positive outcome.
    MeSH term(s) Adult ; Aged ; COVID-19/complications ; COVID-19/mortality ; COVID-19/therapy ; Emergency Service, Hospital ; Female ; Hospitalization ; Humans ; Italy ; Male ; Middle Aged ; Outcome Assessment, Health Care ; Oxygen Inhalation Therapy ; Respiration, Artificial ; Retrospective Studies ; Survival Rate
    Keywords covid19
    Language English
    Publishing date 2020-11-11
    Publishing country Italy
    Document type Journal Article ; Observational Study
    ZDB-ID 2454173-4
    ISSN 1970-9366 ; 1828-0447
    ISSN (online) 1970-9366
    ISSN 1828-0447
    DOI 10.1007/s11739-020-02548-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Risk Stratification in COVID-19 Pneumonia - Determining the Role of Lung Ultrasound.

    Tombini, Valeria / Di Capua, Mirko / Capsoni, Nicolò / Lazzati, Andrea / Bergamaschi, Marta / Gheda, Silvia / Ghezzi, Leonardo / Cassano, Giulio / Albertini, Valentina / Porta, Lorenzo / Zacchino, Massimo / Campanella, Carlo / Guarnieri, Linda / Cazzola, Katia Barbara / Velati, Marta / Di Domenico, Sandro Luigi / Tonani, Michela / Spina, Maria Teresa / Paglia, Stefano /
    Bellone, Andrea

    Ultraschall in der Medizin (Stuttgart, Germany : 1980)

    2021  Volume 43, Issue 2, Page(s) 168–176

    Abstract: LUS patterns of COVID-19 pneumonia have been described and shown to be characteristic. The aim of the study was to predict the prognosis of patients with COVID-19 pneumonia, using a score based on LUS findings.: Materials and methods:  An ... ...

    Title translation Risikostratifizierung bei COVID-19-Pneumonie – Bestimmung der Rolle des Lungen-Ultraschalls.
    Abstract LUS patterns of COVID-19 pneumonia have been described and shown to be characteristic. The aim of the study was to predict the prognosis of patients with COVID-19 pneumonia, using a score based on LUS findings.
    Materials and methods:  An observational, retrospective study was conducted on patients admitted to Niguarda hospital with a diagnosis of COVID-19 pneumonia during the period of a month, from March 2
    Results:  255 patients were enrolled. 93.7 % had a positive LUS. ETI was performed in 43 patients, and 24 received a DNI order. The general mortality rate was 15.7 %. Male sex (OR 3.04, p = 0.014), cardiovascular disease and hypertension (OR 2.75, p = 0.006), P/F (OR 0.99, p < 0.001) and an LUS score > 20 (OR 2.52, p = 0.046) were independent risk factors associated with the primary outcome. Receiver operating characteristic (ROC) curve analysis for an LUS score > 20 was performed with an AUC of 0.837. Independent risk factors associated with the secondary outcome were age (OR 0.96, p = 0.073), BMI (OR 0.87, p = 0,13), P/F (OR 1.03, p < 0.001), and LUS score < 10 (OR 20.9, p = 0.006). ROC curve analysis was performed using an LUS score < 10 with an AUC 0.967.
    Conclusion:  The extent of lung abnormalities evaluated by LUS score is a predictor of a worse outcome, ETI, or death. Moreover, the LUS score could be an additional tool for the safe discharge of patient from the ER.
    MeSH term(s) COVID-19/diagnostic imaging ; Humans ; Lung/diagnostic imaging ; Male ; Retrospective Studies ; Risk Assessment ; SARS-CoV-2 ; Ultrasonography/methods
    Language English
    Publishing date 2021-02-18
    Publishing country Germany
    Document type Journal Article ; Observational Study
    ZDB-ID 801064-x
    ISSN 1438-8782 ; 1439-0914 ; 1431-4894 ; 0172-4614
    ISSN (online) 1438-8782
    ISSN 1439-0914 ; 1431-4894 ; 0172-4614
    DOI 10.1055/a-1344-4715
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1572: Show issues Location:
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  4. Article: Clinical characteristics and respiratory support of 310 COVID-19 patients, diagnosed at the emergency room: a single-center retrospective study

    Di Domenico, Sandro Luigi / Coen, Daniele / Bergamaschi, Marta / Albertini, Valentina / Ghezzi, Leonardo / Cazzaniga, Michela Maria / Tombini, Valeria / Colombo, Riccardo / Capsoni, Nicolò / Coen, Tommaso / Cazzola, Katia Barbara / Di Fiore, Marina / Angaroni, Laura / Strozzi, Marco Alberto

    Intern. emerg. med

    Abstract: An ongoing outbreak of pneumonia associated with severe acute respiratory coronavirus 2 (SARS-CoV-2) occurred at the end of February 2020 in Lombardy, Italy. We analyzed data from a retrospective, single-center case series of 310 consecutive patients, ... ...

    Abstract An ongoing outbreak of pneumonia associated with severe acute respiratory coronavirus 2 (SARS-CoV-2) occurred at the end of February 2020 in Lombardy, Italy. We analyzed data from a retrospective, single-center case series of 310 consecutive patients, with confirmed SARS-CoV-2 infection, admitted to the emergency room. We aimed to describe the clinical course, treatment and outcome of a cohort of patients with COVID-19 pneumonia, with special attention to oxygen delivery and ventilator support. Throughout the study period, 310 consecutive patients, with confirmed SARS-CoV-2 infection, attended the Emergency Room (ER), of these, 34 were discharged home directly from the ER. Of the remaining 276 patients, the overall mortality was 30.4%: 7 patients died in the ER and 77 during hospitalization. With respect to oxygen delivery: 22 patients did not need any oxygen support (8.0%), 151 patients were treated with oxygen only (54.7%), and 49 (17.8%) were intubated. 90 patients (32.6%) were treated with CPAP (Continuous Positive Airway Pressure) or NIV (Non Invasive Ventilation); in this group, 27 patients had a Do Not Intubate (DNI) order and were treated with CPAP/NIV as an upper threshold therapy, showing high mortality rate (88.9%). Among the 63 patients treated with CPAP/NIV without DNI, NIV failure occurred in 36 patients (57.1%), with mortality rate of 47.2%. Twenty-seven (27) patients were treated with CPAP/NIV without needing mechanical ventilation and 26 were discharged alive (96.3%). The study documents the poor prognosis of patients with severe respiratory failure, although a considerable minority of patients treated with CPAP/NIV had a positive outcome.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #919765
    Database COVID19

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  5. Article: Risk Stratification in COVID-19 Pneumonia – Determining the Role of Lung Ultrasound

    Tombini, Valeria / Di Capua, Mirko / Capsoni, Nicolò / Lazzati, Andrea / Bergamaschi, Marta / Gheda, Silvia / Ghezzi, Leonardo / Cassano, Giulio / Albertini, Valentina / Porta, Lorenzo / Zacchino, Massimo / Campanella, Carlo / Guarnieri, Linda / Cazzola, Katia Barbara / Velati, Marta / Di Domenico, Sandro Luigi / Tonani, Michela / Spina, Maria Teresa / Paglia, Stefano /
    Bellone, Andrea

    Ultraschall in der Medizin - European Journal of Ultrasound

    2021  Volume 43, Issue 02, Page(s) 168–176

    Abstract: LUS patterns of COVID-19 pneumonia have been described and shown to be characteristic. The aim of the study was to predict the prognosis of patients with COVID-19 pneumonia, using a score based on LUS findings.: Materials and Methods: An observational, ...

    Abstract LUS patterns of COVID-19 pneumonia have been described and shown to be characteristic. The aim of the study was to predict the prognosis of patients with COVID-19 pneumonia, using a score based on LUS findings.
    Materials and Methods: An observational, retrospective study was conducted on patients admitted to Niguarda hospital with a diagnosis of COVID-19 pneumonia during the period of a month, from March 2 nd to April 3 rd 2020. Demographics, clinical, laboratory, and radiological findings were collected. LUS was performed in all patients. The chest was divided into 12 areas. The LUS report was drafted using a score from 0 to 3 with 0 corresponding to A pattern, 1 corresponding to well separated vertical artifacts (B lines), 2 corresponding to white lung and small consolidations, 3 corresponding to wide consolidations. The total score results from the sum of the scores for each area. The primary outcome was endotracheal intubation, no active further management, or death. The secondary outcome was discharge from the emergency room (ER).
    Results: 255 patients were enrolled. 93.7 % had a positive LUS. ETI was performed in 43 patients, and 24 received a DNI order. The general mortality rate was 15.7 %. Male sex (OR 3.04, p = 0.014), cardiovascular disease and hypertension (OR 2.75, p = 0.006), P/F (OR 0.99, p < 0.001) and an LUS score > 20 (OR 2.52, p = 0.046) were independent risk factors associated with the primary outcome. Receiver operating characteristic (ROC) curve analysis for an LUS score > 20 was performed with an AUC of 0.837. Independent risk factors associated with the secondary outcome were age (OR 0.96, p = 0.073), BMI (OR 0.87, p = 0,13), P/F (OR 1.03, p < 0.001), and LUS score < 10 (OR 20.9, p = 0.006). ROC curve analysis was performed using an LUS score < 10 with an AUC 0.967.
    Conclusion: The extent of lung abnormalities evaluated by LUS score is a predictor of a worse outcome, ETI, or death. Moreover, the LUS score could be an additional tool for the safe discharge of patient from the ER.
    Keywords chest ; point of care ; echocardiography
    Language English
    Publishing date 2021-02-18
    Publisher Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 801064-x
    ISSN 1438-8782 ; 0172-4614 ; 1439-0914 ; 1431-4894
    ISSN (online) 1438-8782
    ISSN 0172-4614 ; 1439-0914 ; 1431-4894
    DOI 10.1055/a-1344-4715
    Database Thieme publisher's database

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