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CORONA (COre ultRasOund of covid in iNtensive care & Acute medicine) Study : national service evaluation of lung and heart ultrasound in intensive care patients with suspected or proven COVID-19
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Parulekar, P., Powys-Lybbe, J., Knight, T., Smallwood, N., Lasserson, Daniel, Rudge, G., Miller, A., Peckham, M. and Aron, J. (2023) CORONA (COre ultRasOund of covid in iNtensive care & Acute medicine) Study : national service evaluation of lung and heart ultrasound in intensive care patients with suspected or proven COVID-19. Journal of the Intensive Care Society, 24 (2). pp. 186-194. doi:10.1177/17511437211065611 ISSN 1751-1437.
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Official URL: https://doi.org/10.1177/17511437211065611
Abstract
Background
Combined Lung Ultrasound (LUS) and Focused UltraSound for Intensive Care heart (FUSIC Heart - formerly Focused Intensive Care Echocardiography, FICE) can aid diagnosis, risk stratification and management in COVID-19. However, data on its application and results are limited to small studies in varying countries and hospitals. This United Kingdom (UK) national service evaluation study assessed how combined LUS and FUSIC Heart were used in COVID-19 Intensive Care Unit (ICU) patients during the first wave of the pandemic.
Method
Twelve trusts across the UK registered for this prospective study. LUS and FUSIC Heart data were obtained, using a standardised data set including scoring of abnormalities, between 1st February 2020 to 30th July 2020. The scans were performed by intensivists with FUSIC Lung and Heart competency as a minimum standard. Data was anonymised locally prior to transfer to a central database.
Results
372 studies were performed on 265 patients. There was a small but significant relationship between LUS score >8 and 30-day mortality (OR 1.8). Progression of score was associated with an increase in 30-day mortality (OR 1.2). 30-day mortality was increased in patients with right ventricular (RV) dysfunction (49.4% vs 29.2%). Severity of LUS score correlated with RV dysfunction (p < 0.05). Change in management occurred in 65% of patients following a combined scan.
Conclusions
In COVID-19 patients, there is an association between lung ultrasound score severity, RV dysfunction and mortality identifiable by combined LUS and FUSIC Heart. The use of 12-point LUS scanning resulted in similar risk score to 6-point imaging in the majority of cases. Our findings suggest that serial combined LUS and FUSIC Heart on COVID-19 ICU patients may aid in clinical decision making and prognostication.
Item Type: | Journal Article | ||||||||
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Subjects: | R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine |
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||||||
Library of Congress Subject Headings (LCSH): | COVID-19 (Disease), COVID-19 (Disease) -- Diagnosis, COVID-19 (Disease) -- Epidemiology , COVID-19 disease -- Patients, Coronavirus infections , Lungs -- Ultrasonic imaging, Echocardiography, Critical care medicine -- Evaluation | ||||||||
Journal or Publication Title: | Journal of the Intensive Care Society | ||||||||
Publisher: | Sage Publications Ltd. | ||||||||
ISSN: | 1751-1437 | ||||||||
Official Date: | May 2023 | ||||||||
Dates: |
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Volume: | 24 | ||||||||
Number: | 2 | ||||||||
Page Range: | pp. 186-194 | ||||||||
DOI: | 10.1177/17511437211065611 | ||||||||
Status: | Peer Reviewed | ||||||||
Publication Status: | Published | ||||||||
Reuse Statement (publisher, data, author rights): | Posted ahead of print. Parulekar, P., Powys-Lybbe, J., Knight, T., Smallwood, N., Lasserson, Daniel, Rudge, G., Miller, A., Peck, M. and Aron, J. (2021) CORONA (COre ultRasOund of covid in iNtensive care & Acute medicine) Study : national service evaluation of lung and heart ultrasound in intensive care patients with suspected or proven COVID-19. Journal of the Intensive Care Society . (In Press) Volume Number and Issue Number) pp. xx-xx. Copyright © [year] (Copyright Holder). Reprinted by permission of SAGE Publications. DOI: [DOI] Users who receive access to an article through a repository are reminded that the article is protected by copyright and reuse is restricted to non-commercial and no derivative uses. | ||||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||||
Description: | Open access but not under license |
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Date of first compliant deposit: | 8 November 2021 | ||||||||
Date of first compliant Open Access: | 10 November 2021 | ||||||||
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