Primary Care Department, Azienda ULSS 3 (Unità Locale Socio Sanitaria) "Serenissima", Veneto Region, Italy.
Department of Prevention, Azienda ULSS 3 (Unità Locale Socio Sanitaria) "Serenissima", Veneto Region, Italy.
J Am Med Dir Assoc. 2020 Oct;21(10):1384-1386. doi: 10.1016/j.jamda.2020.07.034. Epub 2020 Jul 29.
Lung ultrasonographic (LUS) imaging may play an important role in the management of patients with COVID-19-associated lung injury, particularly in some special populations. However, data regarding the prognostic role of the LUS in nursing home residents, one of the populations most affected by COVID-19, are not still available.
Retrospective.
Nursing home residents affected by COVID-19 were followed up with an LUS from April 8 to May 14, 2020, in Chioggia, Venice.
COVID-19 was diagnosed through a nasopharyngeal swab. LUS results were scored using a 12-zone method. For each of the 12 zones (2 posterior, 2 anterior, 2 lateral, for both left and right lungs), the possible score ranged from 0 to 3 (1 = presence of B lines, separated, with <50% of space from the pleural line; 2 = presence of B lines, separated, with >50% of space from the pleural line; 3 = lung thickening with tissuelike aspect). The total score ranged from 0 to 36. Mortality was assessed using administrative data. Data regarding accuracy (and related parameters) were reported.
Among 175 nursing home residents, 48 (mean age: 84.1 years; mainly female) were affected by COVID-19. Twelve died during the follow-up period. The mean LUS score was 3. The area under the curve of LUS in predicting mortality was 0.603 [95% confidence interval (CI): 0.419-0.787], and it increased to 0.725 (95% CI: 0.41-0.99) after including follow-up LUS controls. Taking an LUS score ≥4 as exposure variable and mortality as outcome, the sensitivity was 58.33% and specificity 63.89%, with a positive likelihood ratio of 1.62 and a negative of 0.65.
LUS is able to significantly predict mortality in nursing home residents affected by COVID-19, suggesting that this simple tool can be routinely used in this setting instead of more invasive techniques available only in hospital.
肺部超声（LUS）成像在管理 COVID-19 相关肺损伤患者中可能发挥重要作用，尤其是在某些特殊人群中。然而，关于 LUS 在养老院居民（受 COVID-19 影响最大的人群之一）中的预后作用的数据尚不可用。
回顾性。
2020 年 4 月 8 日至 5 月 14 日，在威尼斯的基奥贾对受 COVID-19 影响的养老院居民进行了 LUS 随访。
通过鼻咽拭子诊断 COVID-19。使用 12 区评分法对 LUS 结果进行评分。对于 12 个区中的每一个（2 个后区、2 个前区、2 个侧区，左右肺各 2 个区），可能的评分范围为 0 至 3（1=存在分隔的 B 线，与胸膜线之间的间隔<50%；2=存在分隔的 B 线，与胸膜线之间的间隔>50%；3=肺实质增厚）。总评分范围为 0 至 36。通过行政数据评估死亡率。报告了准确性（和相关参数）的数据。
在 175 名养老院居民中，有 48 名（平均年龄：84.1 岁；主要为女性）患有 COVID-19。在随访期间有 12 人死亡。平均 LUS 评分为 3。LUS 预测死亡率的曲线下面积为 0.603[95%置信区间（CI）：0.419-0.787]，在纳入随访 LUS 对照后增加到 0.725（95%CI：0.41-0.99）。将 LUS 评分≥4 作为暴露变量，将死亡率作为结局，灵敏度为 58.33%，特异性为 63.89%，阳性似然比为 1.62，阴性似然比为 0.65。
LUS 能够显著预测 COVID-19 养老院居民的死亡率，这表明该简单工具可在该环境中常规使用，而不是仅在医院使用的更具侵入性的技术。
