scholarly journals Lung ultrasound and neonatal COVID-19 pneumonia: A case report.

Author(s):  
Daniel Ibarra Ríos ◽  
Dina Villanueva García ◽  
Edna Patricia Vázquez Solano ◽  
Alfonso de Jesús Martínez García ◽  
Horacio Márquez González

Abstract Purpose: Severe Novel Coronavirus Disease 2019 (COVID-19) infection in neonates is possible but reports are scarce. Lung ultrasound (LUS) has been reported useful for triaging, diagnosing, and monitoring of patients with COVID-19.Material and methods: We describe SARS-CoV-2 confirmed infection on a term newborn that developed pneumonia and pulmonary hypertension requiring mechanical ventilation. Ultrasonographic follow up of COVID-19 pneumonia and pulmonary hypertension was carried out. Results: A 3,140-g male infant born at 40.3 weeks’ gestation developed progressive respiratory distress requiring mechanical ventilation. Real time PCR respiratory tract swabs for SARS COV 2 sampled on day 3 were positive for the baby and both parents. Lung ultrasound showed an irregular pleural line (shred sign), multiple confluent B-lines and bilateral ≥ 0.5 cm subpleural consolidations. Improvement of the lung and cardiac conditions were documented by ultrasound. Conclusion: Our case represents a severe presentation of COVID-19 pneumonia with pulmonary hypertension requiring mechanical ventilation. LUS showed to be useful for diagnosis and follow up.

2020 ◽  
Author(s):  
Daniel Ibarra Ríos ◽  
Dina Villanueva García ◽  
Edna Patricia Vázquez Solano ◽  
Alfonso de Jesús Martínez García ◽  
María Yolotzin Valdespino-Vázquez ◽  
...  

Abstract Introduction: Severe Novel Coronavirus Disease 2019 (COVID-19) infection in neonates is possible but reports are scarce. Lung ultrasound (LUS) has been reported useful for triaging, diagnosing, and monitoring of patients with COVID-19.Material and methods: We describe SARS-CoV-2 confirmed infection on a term newborn that developed pneumonia and pulmonary hypertension requiring mechanical ventilation. Ultrasonographic follow up of COVID-19 pneumonia and pulmonary hypertension was carried out. Histopathological and genetic study of the placenta was performed. Results: A 3,140-g male infant born at 40.3 weeks’ gestation developed progressive respiratory distress (pulmonary hypertension) requiring mechanical ventilation. Real time PCR respiratory tract swabs for SARS COV 2 sampled on day 3 were positive for the baby and both parents. Lung ultrasound showed an irregular pleural line (shred sign), multiple confluent B-lines and bilateral ≥ 0.5 cm subpleural consolidations. Improvement of the lung and cardiac conditions were documented by ultrasound. The newborn was supported 6 days with mechanical ventilation, 3 days on CPAP and 3 days on oxygen. No antibiotics were used. The placenta showed histological findings linked to SARS-CoV-2 infection. RT-PCR from placental tissue showed amplification of viral E gene.Conclusion: Our case represents a severe presentation of COVID-19 pneumonia with pulmonary hypertension requiring mechanical ventilation. LUS showed to be useful for diagnosis and follow up. Transversal infection was possible.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M.J Cristo Ropero ◽  
T Seoane Garcia ◽  
A Izquierdo Bajo ◽  
L Madrona Jimenez ◽  
F.J Rivera Rabanal ◽  
...  

Abstract Background The development of heart failure (HF) is a factor of poor prognosis in patients admitted due to acute coronary syndrome (ACS). Research question The aim of this study is to establish the usefulness of lung ultrasound (LU) to predict patients at risk of developing HF and the need for mechanical ventilation. Methods Prospective study with consecutive inclusion of patients with ACS type infarction without HF on admission and admitted to our centre between February 2017 and 2018. A lung ultrasound was performed in the first 24 hours, considering it positive when they presented 3 or more B lines in two or more quadrants of bilateral form. The result was related to the need for mechanical ventilation. Results We included 119 patients (65.1±12.8 years, 75.6% men), 12.6% presented a need for mechanical ventilation. Patients with a positive LU adjusted for a history of atrial fibrillation and the Killip-Kimball class have a risk 72.79 [95% CI: (9.21, 575.28)] times higher than needing mechanical ventilation at any time of the follow-up Adjusted for sex and heart rate, the result is 101.28 [95% CI: (12.83, 799.15); p=0.00005] times more risk of needing mechanical ventilation at any time of follow-up. Conclusions LU has a high positive predictive value for the development of severe HF and the need for mechanical ventilation, in patients admitted for ACS. Our findings suggest that LU should be incorporated in the initial stratification of patients with ACS. Survival analysis mechanical ventilation Funding Acknowledgement Type of funding source: None


PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256359
Author(s):  
Tatjana Hoffmann ◽  
Peter Bulla ◽  
Lisa Jödicke ◽  
Constantin Klein ◽  
Sarah M. Bott ◽  
...  

Purpose To evaluate whether there is a change in findings of coronavirus disease 2019 patients in follow up lung ultrasound and to determine whether these findings can predict the development of severe disease. Materials and methods In this prospective monocentric study COVID-19 patients had standardized lung ultrasound (12 area evaluation) at day 1, 3 and 5. The primary end point was detection of pathologies and their change over time. The secondary end point was relationship between change in sonographic results and clinical outcome. Clinical outcome was assessed on development of severe disease defined as need for intensive care unit. Results Data of 30 patients were analyzed, 26 patients with follow-up lung ultrasound. All of them showed lung pathologies with dynamic patterns. 26,7% developed severe disease tending to have an ubiquitous lung involvement in lung ultrasound. In patients with need for intensive care unit a previously developed increase in B-lines, subpleural consolidations and pleural line irregularities was more common. A statistically significant association between change in B-lines as well as change in pleural line irregularities and development of severe disease was observed (p<0,01). Conclusion The present study demonstrates that follow up lung ultrasound can be a powerful tool to track the evolution of disease and suggests that lung ultrasound is able to indicate an impending development of severe disease in COVID-19 patients.


Author(s):  
Ying-Hua Sun ◽  
Lin Yuan ◽  
Yang Du ◽  
Jian-Guo Zhou ◽  
Sam Bill Lin ◽  
...  

BACKGROUND: Lung ultrasound (LUS) is a bedside technique that can be used on diagnosis and follow-up of neonatal respiratory diseases. However, there are rare reports on the ultrasound features of bronchopulmonary dysplasia (BPD) which is one of the most common chronic lung diseases in preterm infants. OBJECTIVE: To describe the ultrasound features of different BPD levels, and to investigate the value of ultrasound in evaluating moderate-to-severe BPD. METHODS: In this prospective cohort study, newborns of less than 37 weeks’ gestational age in neonatal intensive care unit (NICU) were included. The LUS characteristics including pleural line, alveolar-interstitial syndrome (AIS), retrodiaphragmatic hyperechogenicity and diaphragmatic morphology were observed and recorded. The reliability of LUS in evaluating moderate and severe BPD were compared and calculated. RESULTS: A total of 108 infants were enrolled in our study: 39, 24, 29, 16 infants had non, mild, moderate and severe BPD. The median(IQR) pleura thickness in the moderate-to-severe BPD group was 1.7(1.6–1.85) mm, which was thicker than that in the none-to-mild BPD infants (P <  0.001), meanwhile the proportions of rough pleural lines, diffuse AIS, retrodiaphragmatic hyperechogenicity, small cysts above the diaphragm and rough diaphragm in the moderate-to-severe BPD group were also higher than those in none-to-mild BPD group (86.7% vs 36.5, 57.8% vs 7.9%, 37.8% vs 0, 33.3% vs 0, P <  0.001). In evaluating moderate-to-severe BPD, rough pleura had 91.1% (95% confidence interval [CI]: 0.793–0.965) in sensitivity, 91.3% (95% CI: 0.797–0.966) in negative predictive value (NPV), and 66.7% (95% CI: 0.544–0.771) in specificity. Small cysts had 100% (95% CI: 0.941-1) in specificity, 100% (95% CI: 0.816-1) in PPV, and 37.8% in sensitivity (95% CI: 0.251–0.524). Rough diaphragm had 100% (95% CI: 0.943-1) in sensitivity, 100% (95% CI: 0.796-1) in PPV and 33.3% (95% CI: 0.211–0.478) in specificity. CONCLUSIONS: Depending on its unique advantages such as convenient, no radiation and repeatable, LUS is a valuable imaging method in assessing the severity of BPD, especially in moderate and severe BPD.


2021 ◽  
Author(s):  
Hayato Taniguchi ◽  
Aimi Ohya ◽  
Hidehiro Yamagata ◽  
Masayuki Iwashita ◽  
Takeru Abe ◽  
...  

Abstract Background: Some patients with severe coronavirus disease (COVID-19) who present with fibrosis on computed tomography (CT) require prolonged mechanical ventilation (PMV). Lung ultrasound (LUS), a rapid, bedside test, has been reported to have findings consistent with those of CT. Thus, this study aimed to assess whether serial LUS scores could predict PMV or successful extubation in severe COVID-19 patients.Methods: LUS was performed for 20 consecutive severe COVID-19 patients at three time points: admission (day 1), after 48 h (day 3), and seventh-day follow-up (day 7). We compared the LUS score with the results of chest X-rays and laboratory tests at three time points. Moreover, we assessed LUS score to determine the inter-rater reliability (IRR) of the results among examiners.Results: While there were no significant differences in mortality in each PMV and successful extubation groups, there were significant differences in LUS scores on day 3 and day 7; XP score on day 7; and P/F ratio on day 7 in the PMV group (p<0.05). There were significant differences in LUS scores on days 3 and 7, C-reactive protein (CRP) levels on day 7, and P/F ratio on day 7 in the successful extubation group (p<0.05). The areas under the curves (AUCs) of LUS score on days 3 and 7, XP score on day 7, and P/F ratio were 0.88, 0.98, 0.77, and 0.80, respectively in the PMV group; and the AUCs of LUS score on days 3 and 7, CRP levels on day 7, and P/F ratio 0.79, 0.90, 0.82, and 0.79, respectively, in the successful extubation group. Variations in serial LUS scores exhibited significant differences between the groups. The serial LUS score on day 7 was higher than that on day 1 in the PMV group but lower in the successful extubation group (p<0.05). However, there was slight IRR agreement in the LUS score changes on days 1 to 7 (κ= 0.15 [95% CI: 0-0.31]). Conclusions: The serial LUS score of severe COVID-19 patients could predicted PMV and successful extubation. To overcome IRR disagreement, the automatic ultrasound judgement, such as deep learning, would be needed.


2020 ◽  
Vol 8 ◽  
pp. 2050313X2095891
Author(s):  
Debo Yun ◽  
Yan Cui ◽  
Yuan Geng ◽  
Yujiao Yang

Knowledge of lung ultrasound characteristics of coronavirus disease 2019 pneumonia might be useful for early diagnosis and clinical monitoring of patients, and lung ultrasound can help to control the spread of infection in healthcare settings. In this case report, a 36-year-old man with severe acute respiratory syndrome coronavirus 2 infection was diagnosed by reverse transcription-polymerase chain reaction testing of a nasopharyngeal swab. The lung ultrasound findings for this patient were the interstitial-alveolar damage showing bilateral, diffuse pleural line abnormalities, subpleural consolidations, white lung areas and thick, irregular vertical artifacts. When the patient recovered from the severe acute respiratory syndrome coronavirus 2 infection, lung ultrasound images showed a normal pleural line with A-lines regularly reverberating. Performing lung ultrasound at the bedside minimizes the need to move the patient, thus reducing the risk of spreading infection among healthcare staff. Lung ultrasound is useful for early diagnosis and evaluation of the severity of coronavirus disease 2019 pneumonia and for monitoring its progress over the course of the disease.


2021 ◽  
Vol 67 (2) ◽  
pp. 73-76
Author(s):  
Bianca Emilia Ciurba ◽  
Hédi Katalin Sárközi ◽  
István Adorján Szabó ◽  
Nimród László ◽  
Edith Simona Ianosi ◽  
...  

Abstract Over the last decades, especially during the COVID-19 pandemic period, lung ultrasound (LUS) gained interest due to multiple advantages: radiation-free, repeatable, cost-effective, portable devices with a bedside approach. These advantages can help clinicians in triage, in positive diagnostic, stratification of disease forms according to severity and prognosis, evaluation of mechanically ventilated patients from Intensive Care Units, as well as monitoring the progress of COVID-19 lesions, thus reducing the health care contamination. LUS should be performed by standard protocol examination. The characteristic lesions from COVID-19 pneumonia are the abolished lung sliding, presence of multiple and coalescent B-lines, disruption and thickening of pleural line with subpleural consolidations. LUS is a useful method for post-COVID-19 lesions evaluation, highlight the remaining fibrotic lesions in some patients with moderate or severe forms of pneumonia.


2020 ◽  
Vol 4 (3) ◽  
pp. 336-339
Author(s):  
Aleq Jaffery ◽  
John Slakey ◽  
David Zodda ◽  
Douglas Finefrock

Introduction: The novel coronavirus disease 2019 (COVID-19) presents a challenge for healthcare providers in terms of diagnosis, management, and triage of cases requiring admission. Case Report: A 47-year-old male with symptoms suspicious for COVID-19, pulse oximetry of 93% on room air, and multifocal pneumonia was risk stratified and safely discharged from the emergency department (ED) despite having moderate risk of progression to acute respiratory distress syndrome. He had resolution of his symptoms verified by telephone follow-up. Conclusion: Various risk-stratifying tools and techniques can aid clinicians in identifying COVID-19 patients who can be safely discharged from the ED.


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