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      Clinical Role of Lung Ultrasound for the Diagnosis and Prognosis of Coronavirus Disease Pneumonia in Elderly Patients: A Pivotal Study

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          Abstract

          Background

          Lung ultrasound (LUS) showed a promising role in the diagnosis and monitoring of patients hospitalized for novel coronavirus disease (COVID-19). However, no data are available on its role in elderly patients.

          Aims

          The aim of this study was to evaluate the diagnostic and prognostic role of LUS in elderly patients hospitalized for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) pneumonia.

          Methods

          Consecutive elderly patients (age >65 years) hospitalized for COVID-19 were enrolled. Demographics, laboratory, comorbidity, and the clinical features of the patients were collected. All patients underwent LUS on admission to the ward. LUS characteristics have been analyzed. Uni- and multivariate analyses to evaluate predictors for in-hospital death were performed.

          Results

          Thirty-seven hospitalized elderly patients (19 men) with a diagnosis of SARS-CoV-2 infection were consecutively enrolled. The median age was 82 years (interquartile range 74.5–93.5). Ultrasound alterations were found in all patients enrolled; inhomogeneous interstitial syndrome with spared areas (91.9%) and pleural alterations (100%) were the most frequent findings. At univariate analysis, LUS score (hazard ratio [HR] 1.168, 95% CI 1.049–1.301) and pleural effusions (HR 3.995, 95% CI 1.056–15.110) were associated with in-hospital death. At multivariate analysis, only LUS score (HR 1.168, 95% CI 1.049–1.301) was independelty associated with in-hospital death. The LUS score's best cutoff for distinguishing patients experiencing in-hospital death was 17 (at multivariate analysis LUS score ≥17, HR 4.827, 95% CI 1.452–16.040). In-hospital death was significantly different according to the LUS score cutoff of 17 ( p = 0.0046).

          Conclusion

          LUS could play a role in the diagnosis and prognosis in elderly patients hospitalized for SARS-CoV-2 infection.

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          Most cited references 34

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          Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy

          In December 2019, a novel coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) emerged in China and has spread globally, creating a pandemic. Information about the clinical characteristics of infected patients who require intensive care is limited.
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            A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation

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              Progress in development of the index of ADL.

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                Author and article information

                Journal
                Gerontology
                Gerontology
                GER
                Gerontology
                S. Karger AG (Allschwilerstrasse 10, P.O. Box · Postfach · Case postale, CH–4009, Basel, Switzerland · Schweiz · Suisse, Phone: +41 61 306 11 11, Fax: +41 61 306 12 34, karger@karger.com )
                0304-324X
                1423-0003
                3 December 2020
                : 1-9
                Affiliations
                aUnit of Internal Medicine, Department of Medical and Surgical Sciences, S. Orsola-Malpighi University Hospital, Bologna, Italy
                bDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
                cAcute Geriatric Unit, S. Orsola-Malpighi University Hospital, Bologna, Italy
                Author notes
                *Guerino Recinella, Department of Medical and Surgical Sciences, S. Orsola-Malpighi University Hospital, Via Pietro Albertoni, 15, IT–40138 Bologna (Italy), guerino.recinella@ 123456gmail.com
                Article
                ger-0001
                10.1159/000512209
                7801997
                33271558
                Copyright © 2020 by S. Karger AG, Basel

                This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.

                Page count
                Figures: 5, Tables: 5, References: 19, Pages: 9
                Categories
                Clinical Section: Research Article

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