Lessons from the pandemic and the value of a structured system of ultrasonographic findings in the diagnosis of COVID-19 pulmonary manifestations

Implementing a structured COVID-19 lung ultrasound system, using COVID-RADS standardization. This case series exams revealed correlations between ultrasonographic and tomographic findings. Ventilatory assessments showed that higher categories required second-line oxygen. This replicable tool will ai...

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Bibliographic Details
Published in:	Einstein (São Paulo, Brazil) Vol. 22; p. eAE0780
Main Authors:	Romano, Vítor Carminatti, Lima, Natália Tavares de Melo Barros, Jabour, Victor Arantes, Del Guerra, Guilherme Ciconelli, Silvério, Paulo Rogério Barboza, Garcia, Rodrigo Gobbo, Sameshima, Yoshino Tamaki, Francisco Neto, Miguel José, Queiroz, Marcos Roberto Gomes de
Format:	Journal Article
Language:	English
Published:	Brazil Instituto Israelita de Ensino e Pesquisa Albert Einstein 01-01-2024
Subjects:	Adolescent Adult Aged Aged, 80 and over Child Child, Preschool Clinical decision making Coronavirus infections COVID-19 COVID-19 - diagnostic imaging Female Humans Infant Lung - diagnostic imaging Lung disease Male MEDICINE, GENERAL & INTERNAL Middle Aged Organ dysfunction Pandemics Retrospective Studies SARS-CoV-2 Severity of Illness Index Special Tomography, X-Ray Computed - methods Ultrasonography Ultrasonography - methods Young Adult COVID-19 Lung disease SARS-CoV-2 Coronavirus infections Clinical decision making Ultrasonography Organ dysfunction
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Summary:	Implementing a structured COVID-19 lung ultrasound system, using COVID-RADS standardization. This case series exams revealed correlations between ultrasonographic and tomographic findings. Ventilatory assessments showed that higher categories required second-line oxygen. This replicable tool will aid in screening and predicting disease severity beyond the pandemic. We aimed to share our experience in implementing a structured system for COVID-19 lung findings, elucidating key aspects of the lung ultrasound score to facilitate its standardized clinical use beyond the pandemic scenario. Using a scoring system to classify the extent of lung involvement, we retrospectively analyzed the ultrasound reports performed in our institution according to COVID-RADS standardization. The study included 69 thoracic ultrasound exams, with 27 following the protocol. The majority of patients were female (52%), with ages ranging from 1 to 96 years and an average of 56 years. Classification according to COVID-RADS was as follows: 11.1% in category 0, 37% in category 1, 44.4% in category 2, and 7.4% in category 3. Ground-glass opacities on tomography correlated with higher COVID-RADS scores (categories 2 and 3) in 82% of cases. Ventilatory assessment revealed that 50% of cases in higher COVID-RADS categories (2 and 3) required second-line oxygen supplementation, while none of the cases in lower categories (0 and 1) utilized this support. Lung ultrasound has been widely utilized as a diagnostic tool owing to its availability and simplicity of application. In the context of the pandemic emergency, a pressing need for a focused and easily applicable assessment arose. The structured reporting system, incorporating ultrasound findings for stratification, demonstrated ease of replicability. This system stands as a crucial tool for screening, predicting severity, and aiding in medical decisions, even in a non-pandemic context. Lung ultrasound enables precise diagnosis and ongoing monitoring of the disease. Ultrasound is an effective tool for assessing pulmonary findings in COVID-19. Structured reports enhance communication and are easily reproducible.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Conflict of interest: none. Associate Editor: Kenneth Gollob Hospital Israelita Albert Einstein, São Paulo, SP, Brazil ORCID: https://orcid.org/0000-0003-4184-3867
ISSN:	1679-4508 2317-6385 2317-6385
DOI:	10.31744/einstein_journal/2024AE0780