Kalkanis Alexandros, Schepers Christophe, Louvaris Zafeiris, Godinas Laurent, Wauters Els, Testelmans Dries, Lorent Natalie, Van Mol Pierre, Wauters Joost, De Wever Walter, Dooms Christophe
Department of Respiratory Diseases, University Hospitals, Katholieke Universiteit Leuven, 3000 Leuven, Belgium.
Department of Radiology, University Hospitals, Katholieke Universiteit Leuven, 3000 Leuven, Belgium.
J Clin Med. 2022 May 11;11(10):2718. doi: 10.3390/jcm11102718.
We conducted a prospective single-center observational study to determine lung ultrasound reliability in assessing global lung aeration in 38 hospitalized patients with non-critical COVID-19. On admission, fixed chest CT scans using visual (CTv) and software-based (CTs) analyses along with lung ultrasound imaging protocols and scoring systems were applied. The primary endpoint was the correlation between global chest CTs score and global lung ultrasound score. The secondary endpoint was the association between radiographic features and clinical disease classification or laboratory indices of inflammation. Bland−Altman analysis between chest CT scores obtained visually (CTv) or using software (CTs) indicated that only 1 of the 38 paired measures was outside the 95% limits of agreement (−4 to +4 score). Global lung ultrasound score was highly and positively correlated with global software-based CTs score (r = 0.74, CI = 0.55−0.86; p < 0.0001). Significantly higher median CTs score (p = 0.01) and lung ultrasound score (p = 0.02) were found in severe compared to moderate COVID-19. Furthermore, we identified significantly lower (p < 0.05) lung ultrasound and CTs scores in those patients with a more severe clinical condition manifested by SpO2 < 92% and C-reactive protein > 58 mg/L. We concluded that lung ultrasound is a reliable bedside clinical tool to assess global lung aeration in hospitalized non-critical care patients with COVID-19 pneumonia.
我们进行了一项前瞻性单中心观察性研究,以确定肺部超声在评估38例非重症COVID-19住院患者的全肺通气情况时的可靠性。入院时,采用了基于视觉(CTv)和软件(CTs)分析的固定胸部CT扫描,同时应用了肺部超声成像方案和评分系统。主要终点是全肺CT评分与全肺超声评分之间的相关性。次要终点是影像学特征与临床疾病分类或炎症实验室指标之间的关联。对通过视觉(CTv)或使用软件(CTs)获得的胸部CT评分进行的Bland−Altman分析表明,38对测量值中只有1对超出了95%一致性界限(-4至+4分)。全肺超声评分与基于软件的全肺CTs评分高度正相关(r = 0.74,CI = 0.55−0.86;p < 0.0001)。与中度COVID-19相比,重度患者的CTs评分中位数(p = 0.01)和肺部超声评分中位数(p = 0.02)显著更高。此外,我们发现,对于那些以SpO2 < 92%和C反应蛋白> 58 mg/L为特征的临床病情更严重的患者,其肺部超声和CTs评分显著更低(p < 0.05)。我们得出结论,肺部超声是评估非重症COVID-19肺炎住院患者全肺通气情况的可靠床边临床工具。