CORONA (Core ultrasound of Covid in intensive care and acute medicine study : national service evaluation of lung and heart ultrasound in intensive care patients with suspected or proven COVID-19
Author
Parulekar, PrashantPowys-Lybbe, James
Knight, Thomas
Smallwood, Nicholas
Lasserson, Daniel
Rudge, Gavin
Miller, Ashley
Peck, Marcus
Aron, Jonathon
Affiliation
William Harvey Hospital NHS Foundation Trust; Sandwell and West Birmingham NHS Trust; St George's Hospital; Surrey and Sussex Healthcare NHS Trust et al.Publication date
2022-01-10Subject
Practice of medicine
Metadata
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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.Citation
Parulekar P, Powys-Lybbe J, Knight T, Smallwood N, Lasserson D, Rudge G, Miller A, Peck M, Aron J. CORONA (COre ultRasOund of covid in iNtensive care and Acute medicine) study: National service evaluation of lung and heart ultrasound in intensive care patients with suspected or proven COVID-19. J Intensive Care Soc. 2023 May;24(2):186-194. doi: 10.1177/17511437211065611Type
ArticlePMID
37255992Publisher
SAGE Publicationsae974a485f413a2113503eed53cd6c53
10.1177/17511437211065611