Department of Cardiology, Tel Aviv Sourasky Medical Center and Sackler School of Medicine, Tel Aviv University, Weizmann 6, Tel Aviv 6423919, Israel.
The Intensive Care Unit, Tel-Aviv Sourasky Medical Center and Sackler school of Medicine, Tel-Aviv University, Weizmann 6, Tel Aviv 6423919, Israel.
Eur Heart J Cardiovasc Imaging. 2022 Dec 19;24(1):59-67. doi: 10.1093/ehjci/jeac212.
Preliminary data suggested that patients with Omicron-type-Coronavirus-disease-2019 (COVID-19) have less severe lung disease compared with the wild-type-variant. We aimed to compare lung ultrasound (LUS) parameters in Omicron vs. wild-type COVID-19 and evaluate their prognostic implications.
One hundred and sixty-two consecutive patients with Omicron-type-COVID-19 underwent LUS within 48 h of admission and were compared with propensity-matched wild-type patients (148 pairs). In the Omicron patients median, first and third quartiles of the LUS-score was 5 [2-12], and only 9% had normal LUS. The majority had either mild (≤5; 37%) or moderate (6-15; 39%), and 15% (≥15) had severe LUS-score. Thirty-six percent of patients had patchy pleural thickening (PPT). Factors associated with LUS-score in the Omicron patients included ischaemic-heart-disease, heart failure, renal-dysfunction, and C-reactive protein. Elevated left-filling pressure or right-sided pressures were associated with the LUS-score. Lung ultrasound-score was associated with mortality [odds ratio (OR): 1.09, 95% confidence interval (CI): 1.01-1.18; P = 0.03] and with the combined endpoint of mortality and respiratory failure (OR: 1.14, 95% CI: 1.07-1.22; P < 0.0001). Patients with the wild-type variant had worse LUS characteristics than the matched Omicron-type patients (PPT: 90 vs. 34%; P < 0.0001 and LUS-score: 8 [5, 12] vs. 5 [2, 10], P = 0.004), irrespective of disease severity. When matched only to the 31 non-vaccinated Omicron patients, these differences were attenuated.
Lung ultrasound-score is abnormal in the majority of hospitalized Omicron-type patients. Patchy pleural thickening is less common than in matched wild-type patients, but the difference is diminished in the non-vaccinated Omicron patients. Nevertheless, even in this milder form of the disease, the LUS-score is associated with poor in-hospital outcomes.
初步数据表明，与野生型变异株相比，感染奥密克戎型 2019 冠状病毒病（COVID-19）的患者肺部疾病较轻。我们旨在比较奥密克戎与野生型 COVID-19 的肺部超声（LUS）参数，并评估其预后意义。
162 例连续的奥密克戎型 COVID-19 患者在入院后 48 小时内行 LUS 检查，并与倾向评分匹配的野生型患者（148 对）进行比较。奥密克戎患者的中位数、第一四分位数和第三四分位数的 LUS 评分为 5[2-12]，仅有 9%的患者 LUS 正常。大多数患者的 LUS 评分较轻（≤5，37%）或中度（6-15，39%），15%（≥15）的患者 LUS 评分严重。36%的患者有斑片状胸膜增厚（PPT）。与奥密克戎患者 LUS 评分相关的因素包括缺血性心脏病、心力衰竭、肾功能不全和 C 反应蛋白。左心房充盈压或右心压力升高与 LUS 评分相关。LUS 评分与死亡率相关[比值比（OR）：1.09，95%置信区间（CI）：1.01-1.18；P = 0.03]，与死亡率和呼吸衰竭的联合终点相关（OR：1.14，95%CI：1.07-1.22；P < 0.0001）。与匹配的奥密克戎型患者相比，野生型变异株患者的 LUS 特征更差（PPT：90%比 34%；P < 0.0001 和 LUS 评分：8[5,12]比 5[2,10]；P = 0.004），无论疾病严重程度如何。当仅与 31 例未接种疫苗的奥密克戎患者相匹配时，这些差异减弱。
大多数住院奥密克戎型患者的 LUS 评分异常。与匹配的野生型患者相比，斑片状胸膜增厚不常见，但在未接种疫苗的奥密克戎患者中差异减弱。然而，即使在这种较轻的疾病形式中，LUS 评分也与住院不良预后相关。
