Bedside wireless lung ultrasound for the evaluation of COVID-19 lung injury in senior nursing home residents

Monaldi Arch Chest Dis. 2020 Sep 2;90(3). doi: 10.4081/monaldi.2020.1446.

Abstract

Lung Ultrasound (LUS) is regarded to be potentially useful to diagnose lung injury in older adults living in nursing homes with suspected COVID-19 pneumonia. We aimed at evaluating presence lung injury among senior nursing home residents by LUS performed with portable wireless scanner echography. The study population consisted of 150 residents with a mean age of 88 years (85% female) residing in 12 nursing homes in Northern Italy. Subjects had to have a history of recent onset of symptoms compatible with COVID-19 pneumonia or have been exposed to the contagion of patients carrying the disease. COVID-19 testing was performed with SARS-CoV-2 nasal-pharyngeal (NP) swabs. Positive subjects to LUS scanning were considered those with non-coascelent B-lines in >3 zones, coalescent B-lines in >3 zones and with iperdensed patchy non-consolidated lungs. Sixty-three percent had positive NP testing and 65% had LUS signs of pulmonary injury. LUS had a sensitivity of 79% in predicting positive NP testing. Sixteen percent of residents tested negative for SARSCoV-2 carried the signs of COVID-19 lung injury at LUS. There were 92 patients (61%) with current or recent symptoms.Positivity to LUS scanning was reported in 73% of residents with symptoms, while it was 53% in those without (P=0.016). A positive NP testing was observed in 66% of residents with symptoms and in 57% of those without (P=0.27). We conclude that assessment of LUS by portable wireless scanner echography can be profitability utilized to diagnose lung injury among senior nursing home residents with or without symptoms compatible with COVID-19 pneumonia.

MeSH terms

  • Aged, 80 and over
  • Betacoronavirus / isolation & purification
  • Coronavirus Infections* / diagnosis
  • Coronavirus Infections* / epidemiology
  • Coronavirus Infections* / physiopathology
  • Female
  • Homes for the Aged / statistics & numerical data
  • Humans
  • Italy / epidemiology
  • Lung Injury / diagnostic imaging*
  • Male
  • Nursing Homes / statistics & numerical data
  • Pandemics*
  • Pneumonia, Viral / diagnosis*
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / etiology
  • Pneumonia, Viral / physiopathology
  • Point-of-Care Testing*
  • Predictive Value of Tests
  • Sensitivity and Specificity
  • Ultrasonography* / instrumentation
  • Ultrasonography* / methods
  • Wireless Technology

Supplementary concepts

  • COVID-19
  • severe acute respiratory syndrome coronavirus 2