1887
Volume 2022, Issue 5
  • ISSN: 1999-7086
  • EISSN: 1999-7094

Abstract

Lung ultrasound is a point-of-care diagnostic work-up tool used extensively in emergency departments. The COVID-19 Lung Ultrasound in Emergency Department (CLUE) protocol has shown initial promise in aiding emergency clinicians to make rapid and appropriate bedside clinical decisions. Its primary objective is to assess the performance of the lung ultrasound scoring system (LUSS) in determining SARS-CoV-2 pneumonia severity so that the patients can be moved to their designated ICUs, wards, or facility quarantine center from the emergency department.

A cross-sectional study was undertaken among adult patients with a confirmed diagnosis of SARS-CoV-2 infection who were admitted/referred to the All India Institute of Medical Sciences, Rishikesh, Uttarakhand. The data were descriptively analyzed using Graphpad Prism (vs. 9.2.0).

Out of 197 patients included in this study, 74.6% were men with a mean age of 45.3 ± 15.5 years. The men to women ratio was 2.9:1. The most frequent symptoms on presentation were fever (59.9% of cases), cough (54.3%), dyspnea (36%), and 16.2% of the patients were asymptomatic. The mean LUSS score of the patients with invasive support was 24.3 ± 4.5, as compared to 15.7 ± 5.9 in the non-invasive group. Overall, 64.4% patients did not require any respiratory support with a mean LUSS score of 2.3 ± 3.5. Out of 197 patients, 5 (2.5%) died during hospital stay. The mean LUSS score of survivors was 7.1 ± 8.2, as compared to 22.2 ± 4.3 of the deceased.

The CLUE protocol can help in triaging the patients in the mild and moderate severity group and discharging them directly from the emergency department itself to either a facility quarantine center or to home isolation. It ultimately helps in avoiding unnecessary referrals, eliminating contamination, and optimum utilization of health resources.

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2022-12-01
2024-11-08
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References

  1. World Health Organization, Regional Office for Eastern Mediterranean. COVID-19 situation updates. [Internet] [Accessed 19 February 2022]. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019
    [Google Scholar]
  2. Ai T, Yang Z, Hou H, Zhan C, Chen C, Lv W, et al. Correlation of chest CT and RT-PCR testing for corona-virus disease 2019 (COVID-19) in China: A report of 1014 cases. Radiology. 2020Aug; 296:(2):E32–E40.
    [Google Scholar]
  3. Ng MY, Lee EYP, Yang J, Yang F, Li X, Wang H, et al. Imaging profile of the COVID-19 infection: Radiologic findings and literature review. Radiol Cardiothorac Imaging. 2020Feb; 2:(1):e200034.
    [Google Scholar]
  4. Manivel V, Lesnewski A, Shamim S, Carbonatto G, Govindan T. CLUE: COVID-19 lung ultrasound in emergency department. Emerg Med Australas. 2020Aug; 32:(4):694–6.
    [Google Scholar]
  5. Chavez MA, Shams N, Ellington LE, Naithani N, Gilman RH, Steinhoff MC, et al. Lung ultrasound for the diagnosis of pneumonia in adults: a systematic review and meta-analysis. Respir Res. 2014Apr; 15:(1):50.
    [Google Scholar]
  6. Ticinesi A, Scarlata S, Nouvenne A, Lauretani F, Incalzi RA, Ungar A; GRETA (Gruppo di Ricerca sull’Ecografia Toracica nell’Anziano) Group of the Italian Society of Gerontology and Geriatrics (SIGG). The geriatric patient: The ideal one for chest ultrasonography? A review from the chest ultrasound in the elderly study group (GRETA) of the Italian Society of Gerontology and Geriatrics (SIGG). J Am Med Dir Assoc. 2020Apr; 21:(4):447–54.e6.
    [Google Scholar]
  7. Gao Y, Li T, Han M, Li X, Wu D, Xu Y, et al. Diagnostic utility of clinical laboratory data determinations for patients with the severe COVID-19. J Med Virol. 2020Jul; 92:(7):791–6.
    [Google Scholar]
  8. Staub LJ, Biscaro RRM, Kaszubowski E, Maurici R. Lung ultrasound for the emergency diagnosis of pneumonia, acute heart failure, and exacerbations of chronic obstructive pulmonary disease/asthma in adults: a systematic review and meta-analysis. J Emerg Med. 2019; 56::53–69.
    [Google Scholar]
  9. Asano M, Watanabe H, Sato K, Okuda Y, Sakamoto S, Hasegawa Y, et al. Validity of ultrasound lung comets for assessment of the severity of interstitial pneumonia. J Ultrasound Med. 2018; 37::1523–31.
    [Google Scholar]
  10. Patel CJ, Bhatt HB, Parikh SN, Jhaveri BN, Puranik JH. Bedside lung ultrasound in emergency protocol as a di-agnostic tool in patients of acute respiratory distress presenting to emergency department. J Emerg Trauma Shock. 2018; 11::125–9.
    [Google Scholar]
  11. Man MA, Dantes E, Domokos Hancu BD, Bondor CI, Ruscovan A, et al. Correlation between transthoracic lung ultrasound score and HRCT features in patients with interstitial lung diseases. J Clin Med. 2019; 8::1199.
    [Google Scholar]
  12. Mayo PH, Copetti R, Feller-Kopman D, Mathis G, Maury E, Mongodi S, et al. Thoracic ultrasonography: A narrative review. Intensive Care Med. 2019; 45::1200–11.
    [Google Scholar]
  13. Peng Q-Y, Wang X-T, Zhang L-N. Findings of lung ultrasonography of novel corona virus pneumonia during the 2019–2020 epidemic. Intensive Care Med. 2020; 46::849–50.
    [Google Scholar]
  14. Xing C, Li Q, Du H, Kang W, Lian J, Yuan L. Lung ultrasound findings in patients with COVID-19 pneumonia. Crit Care. 2020; 24::174.
    [Google Scholar]
  15. Lu W, Zhang S, Chen B, Chen J, Xian J, Lin Y, et al. A clinical study of noninvasive assessment of lung lesions in patients with Coronavirus Disease-19 (COVID-19) by bedside ultrasound. Ultraschall Med. 2020; 41::300–7.
    [Google Scholar]
  16. Soldati G, Smargiassi A, Inchingolo R, Buonsenso D, Perrone T, Briganti DF, et al. Proposal for international standardization of the use of lung ultrasound for patients with COVID-19: A simple, quantitative, reproducible method. J Ultrasound Med. 2020; 39::1413–9.
    [Google Scholar]
  17. Weile J, Frederiksen CA, Laursen CB, Graumann O, Sloth E, Kirkegaard H. Point-of-care ultrasound induced changes in management of unselected patients in the emergency department – a prospective single-blinded observational trial. Scand J Trauma Resusc Emerg Med. 2020May; 28:(1):47.
    [Google Scholar]
  18. Nouvenne A, Zani MD, Milanese G, Parise A, Baciarello M, Bignami EG, et al. Lung ultrasound in COVID-19 pneumonia: Correlations with chest CT on hospital admission. Respiration. 2020; 99:(7):617–24.
    [Google Scholar]
  19. Sen KK, Dubey R, Goyal M, Sethi H, Sharawat A, Arora R. COVITALE 2020 from eastern Indian population: im-ageologists perspective, a learning curve. Egypt J Radiol Nucl Med. 2021; 52::251. https://doi.org/10.1186/s43055-021-00634-7
    [Google Scholar]
  20. Volpicelli G, Lamorte A, Villen T. What’s new in lung ultrasound during the COVID-19 pandemic. Intensive Care Med. 2020; 46::1445–8.
    [Google Scholar]
  21. Alharthy A, Faqihi F, Abuhamdah M, Noor A, Naseem N, Balhamar A, et al. Prospective longitudinal evaluation of point-of-care lung ultrasound in critically Ill patients with severe COVID-19 pneumonia. J Ultrasound Med. 2020; 40::443–56.
    [Google Scholar]
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