None listed
Conditions
Brief summary
Lung ultrasound (LUS) is known to be more sensitive for detection of lung pathology compared to plain radiography and comparable to computerised tomography (CT), particularly for peripheral or pleurally based lesions. For example, it can be used in diagnosing interstitial patterns including pulmonary edema, as well as consolidation and effusions. Point-of-care (POCUS) is readily available in most emergency departments (ED), where it can immediately supply clinical information at the bedside. SARS-CoV-2 viral pneumonia (COVID-19) has led some practitioners to assess if LUS has utility in its diagnosis or prognosis. There are specific findings which represent viral pneumonias, such as increasing density of B-lines, subpleural consolidations, and absence of pleural effusions. Unfortunately LUS is currently unable to distinguish COVID-19 from other viral pneumonias but may be possible with further description of findings in a large cohort of patients. Although the current de facto “gold standard” for COVID-19 diagnosis, reverse-transcriptase polymerase chain reaction (RT-PCR) has a delayed turnaround of results and lacks sensitivity, particularly early in the course of the illness. Although LUS is unlikely to replace nucleic acid testing for definitive diagnosis, it may have utility in predicting clinical deterioration indicating need for ventilatory support. If proven to be accurately predictive of clinical deterioration, LUS findings could be integrated with clinical findings at the time of ED presentation, to triage patients to either outpatient management (low risk features), ward admission (moderate risk features) or intensive care unit (ICU) admission (high risk features). This could impact patient outcomes, resource allocation, and departmental flow, particularly in times of crisis. Furthermore, the findings from this study may inform the use of LUS in future respiratory virus pandemics.
Interventions
Patients presenting to the emergency department suspected of having COVID-19, who are admitted to hospital, will have lung ultrasound (LUS) findings recorded and compared against COVID-19 status and outcomes. LUS images will be collected alongside data collected from routine care of patients. For many sites LUS is part of routine care of these patients. Patients will be followed until discharge, for a maximum of 12 months.
Sponsors
Monash Hospital
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patients aged 18 years or older who: Present to the emergency department with suspected or confirmed COVID-19 disease, who have been swabbed (either in the ED or prior to attending ED) Are being admitted with suspected or proven diagnosis of COVID-19 Have a lung ultrasound performed by credentialed provider in the ED
Exclusion criteria
Patient already enrolled in the current study Patient deemed for palliative/comfort care approach Lung US images not recorded, or inadequate, for review Prior pneumonectomy or other significant pre-existing lung pathology or treatment e.g. malignancy, pleurodesis, fibrosis. Patient unable to provide consent.
Outcome results
None listed