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      Feasibility of a 5G-based robot-assisted remote ultrasound system for cardiopulmonary assessment of COVID-19 patients

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          Abstract

          Background

          Traditional methods for cardiopulmonary assessment of Coronavirus Disease 2019 (COVID-19) patients pose risks to, both, patients and examiners. This necessitates a remote examination of such patients without sacrificing information quality.

          Research Question

          Assess the feasibility of a 5G-based robot-assisted remote ultrasound system in examining COVID-19 patients and establish an examination protocol for telerobotic ultrasound scanning.

          Study Design and Methods

          Twenty-three COVID-19 patients were included and divided into two groups. Twelve were non-severe cases, and 11 were severe cases. All patients underwent a 5G-based robot-assisted remote ultrasound system examination of the lungs and heart following an established protocol. Distribution characteristics and morphology of the lung and surrounding tissue lesions, left ventricular ejection fraction (LVEF), ventricular area ratio, pericardial effusion, and examination-related complications were recorded. Bilateral lung lesions were evaluated by lung ultrasound score (LUS).

          Results

          The remote ultrasound system successfully and safely performed cardiopulmonary examinations of all patients. Peripheral lung lesions were clearly evaluated. Severe cases had significantly more diseased regions [median (interquartile range), 6.0 (2.0-11.0) vs. 1.0 (0.0-2.8)] and higher LUSs [12.0 (4.0-24.0) vs. 2.0 (0.0-4.0)] than non-severe cases (both, P < 0.05 ). One non-severe case (8.3%, 95%CI, 1.5% to 35.4%) and three severe cases (27.3%, 95%CI, 9.7% to 56.6%) were complicated by pleural effusions. Four severe cases (36.4%, 95%CI, 15.2% to 64.6%) were complicated by pericardial effusions (vs 0% of non-severe cases, P < 0.05). No patients had significant examination-related complications.

          Interpretation

          5G-based robot-assisted remote ultrasound system is feasible, and effectively obtains ultrasound characteristics for cardiopulmonary assessment of COVID-19 patients. By following established protocols and considering medical history, clinical manifestations, and laboratory markers, it might help to evaluate the severity of COVID-19 remotely.

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          Author and article information

          Contributors
          Journal
          Chest
          Chest
          Chest
          Published by Elsevier Inc under license from the American College of Chest Physicians.
          0012-3692
          1931-3543
          9 July 2020
          9 July 2020
          Affiliations
          [1 ]Department of Ultrasound Medicine, Zhejiang Provincial People's Hospital & People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, 310014, China
          [2 ]Emergency Center, Hubei Clinical Research Center for Emergency and Resuscitation, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China
          [3 ]Medical aiding team for COVID-19 in Hubei, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, 310014, China
          [4 ]MGI Tech Co., Ltd, Shenzhen, Guangdong, 518000, China
          [5 ]Gennlife (Beijing) Biotechnology Co. Ltd, Haidian, Beijing, 100080, China
          Author notes
          [∗∗ ]Corresponding Author: Legao Chen, MD., Medical aiding team for COVID-19 in Hubei, Zhejiang Provincial People's Hospital, 158 Shangtang Road, Hangzhou, Zhejiang, 310014, China. chenlegao@ 123456126.com
          [∗]

          These two authors contributed equally to the article and should be considered co-first authors.

          Article
          S0012-3692(20)31870-5
          10.1016/j.chest.2020.06.068
          7347315
          32653568
          e7375656-cc14-4cb3-b5db-c6df7938732d
          © 2020 The Authors

          Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

          History
          : 26 April 2020
          : 20 June 2020
          : 27 June 2020
          Categories
          Article

          Respiratory medicine
          covid-19,lung diseases,robotics,telemedicine,ultrasound,covid-19, corona virus disease 2019,dof, degree of freedom,lvef, left ventricular ejection fraction,hrct, high-resolution computed tomography,lus, lung ultrasound score,rveda/lveda, right ventricular end-diastolic area /left ventricular end-diastolic area

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