Chest ultrasound is a very useful tool for identifying which patients may have a worse outcome due to pneumonia caused by Covid-19, as revealed by a study carried out by Hospital del Mar, Doctors Without Borders and Epicentre, an MSF division dedicated to epidemiology and medical research.
This research, published in the journal Journal of Clinical Medicineestablishes a useful scale to discern what Patients are at higher risk of developing serious complications due to infection caused by SARS-CoV-2, which may require admission to an intensive care unit and/or require invasive ventilation.
In the image, a professional performing a chest ultrasound
The study was carried out during the first waves of the pandemic, from August 2020 to April 2021. More than 600 ultrasounds for 248 patients hospitalized for Covid-19 at the Hospital del Marwith the aim of determining whether this technique could predict the evolution of the disease. The evaluation consisted of examine the state of the lungs in twelve different areas and assign a score based on the images obtained.
Of the 248 patients evaluated, with a average age 60 yearstwo-thirds were men. Thirteen patients died and 36 required ICU admission. The average hospital stay for those who survived was 8.5 days.
The study has determined that patients with a chest ultrasound score of 17 points or more, out of a total of 36, present up to four times more risk of experiencing an adverse evolution.
This negative evolution could mean in the admission of the patient to the ICU or in the need for mechanical ventilation. In some cases, this could even lead to the death of the patient. Therefore, a early intervention, including oxygen therapyOn the other hand, the study determined that patients with a score below seven could be considered as non-serious and treated with the standard protocol.
He Dr. Robert Güerrihead of the Infectious Diseases Department at Hospital del Mar, researcher at its research institute and one of the signatories of the work, highlights that «During the first wave of Covid-19, this study was carried out to evaluate the Diagnostic and prognostic utility of lung ultrasound in the follow-up of patients with Covid-19“This study allowed many professionals, especially resident physicians, to become familiar with the use of ultrasound, discovering its versatility and clinical usefulness.”
The work, in which the resident doctors who completed their training at the Hospital del Mar have played a decisive role, also highlights that Repeating the test 72 hours after the patient’s admission does not improve its prognostic capacity.
Clinical ultrasound facilitates informed decision making
As explained by the section head of the Infectious Diseases Service of the Hospital of the Sea, “After the initial waves of Covid-19, the The use of clinical ultrasound has spread among healthcare professionals from various medical areas. It has become a both diagnostic and prognostic tool, facilitating informed decision making. Physicians have embraced ultrasound to rapidly assess patients, improving treatment efficiency and accuracy in a demanding and dynamic clinical environment.».
The study confirms the Utility of this diagnostic test in Covid-19 and points to its potential use in other viral diseases with lung involvement. As noted Cristian Casademontmedical director of MSF, «Since 2018, MSF has had a training and implementation plan portable ultrasound to train healthcare personnel on projects and improve patient care».
«It is a Fast and effective diagnostic tool with the potential to substantially improve the quality of care. For example, MSF recently conducted a study in South Sudan and Guinea Bissau on how ultrasound facilitates the diagnosis of paediatric patients with tuberculosis.indica
This study has been made possible thanks to the support, among others, of the fund Transformational Investment Capacity (ICT) of Doctors Without Borders (MSF), which prioritized among its projects the training, advanced use and research of Point-of-Care Ultrasound (POCUS).
Interested persons can See the study here «Evaluation of a Lung Ultrasound Score in Hospitalized Adult Patients with COVID-19 in Barcelona».
