Multi-organ point-of-care ultrasound for COVID-19 (PoCUS4COVID): international expert consensus

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

COVID-19 has caused great devastation in the past year. Multi-organ point-of-care ultrasound (PoCUS) including lung ultrasound (LUS) and focused cardiac ultrasound (FoCUS) as a clinical adjunct has played a significant role in triaging, diagnosis and medical management of COVID-19 patients. The expert panel from 27 countries and 6 continents with considerable experience of direct application of PoCUS on COVID-19 patients presents evidence-based consensus using GRADE methodology for the quality of evidence and an expedited, modified-Delphi process for the strength of expert consensus. The use of ultrasound is suggested in many clinical situations related to respiratory, cardiovascular and thromboembolic aspects of COVID-19, comparing well with other imaging modalities. The limitations due to insufficient data are highlighted as opportunities for future research.

Related collections

Most cited references 94

Record: found
Abstract: found
Article: not found

Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

Chaolin Huang, Yeming Wang, Xingwang Li … (2020)

Summary Background A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients. Methods All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not. Findings By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0–58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0–13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα. Interpretation The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies. Funding Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission.

0 comments Cited 21878 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

Fei Zhou, Ting Yu, Ronghui Du … (2020)

Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p<0·0001), and d-dimer greater than 1 μg/mL (18·42, 2·64–128·55; p=0·0033) on admission. Median duration of viral shedding was 20·0 days (IQR 17·0–24·0) in survivors, but SARS-CoV-2 was detectable until death in non-survivors. The longest observed duration of viral shedding in survivors was 37 days. Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.

0 comments Cited 13478 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

COVID-19 and Cardiovascular Disease

Kevin Clerkin, Justin Fried, Jayant Raikhelkar … (2020)

Coronavirus disease 2019 (COVID-19) is a global pandemic affecting 185 countries and >3 000 000 patients worldwide as of April 28, 2020. COVID-19 is caused by severe acute respiratory syndrome coronavirus 2, which invades cells through the angiotensin-converting enzyme 2 receptor. Among patients with COVID-19, there is a high prevalence of cardiovascular disease, and >7% of patients experience myocardial injury from the infection (22% of critically ill patients). Although angiotensin-converting enzyme 2 serves as the portal for infection, the role of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers requires further investigation. COVID-19 poses a challenge for heart transplantation, affecting donor selection, immunosuppression, and posttransplant management. There are a number of promising therapies under active investigation to treat and prevent COVID-19.

0 comments Cited 808 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Arif Hussain:

ORCID: http://orcid.org/0000-0002-4143-0475

hussain_pscc@hotmail.com

Journal

Journal ID (nlm-ta): Crit Care

Title: Critical Care

Publisher: BioMed Central (London )

ISSN (Print): 1364-8535

ISSN (Electronic): 1466-609X

Publication date (Electronic): 24 December 2020

Publication date PMC-release: 24 December 2020

Publication date Collection: 2020

Volume: 24

Electronic Location Identifier: 702

Affiliations

[1 ]Department of Cardiac Sciences, King Abdulaziz Medical City and King Abdullah International Medical Research Center, Riyadh, Saudi Arabia

[2 ]GRID grid.7400.3, ISNI 0000 0004 1937 0650, Cardiac Anesthesia and Intensive Care, , Cardiocentro Ticino, ; Lugano, Switzerland

[3 ]GRID grid.415436.1, ISNI 0000 0004 0443 7314, New York Presbyterian Brooklyn Methodist Hospital, ; New York, NY USA

[4 ]GRID grid.17063.33, ISNI 0000 0001 2157 2938, Department of Medicine and Interdepartmental Division of Critical Care Medicine, , University of Toronto, ; Toronto, Canada

[5 ]GRID grid.8982.b, ISNI 0000 0004 1762 5736, Department of Clinical-Surgical, Diagnostic and Paediatric Sciences, Unit of Anaesthesia and Intensive Care, , University of Pavia, ; Pavia, Italy

[6 ]GRID grid.419425.f, ISNI 0000 0004 1760 3027, Anaesthesia and Intensive Care, , Fondazione Istituto Di Ricovero E Cura a Carattere Scientifico, Policlinico San Matteo Foundation, ; Pavia, Italy

[7 ]Emergency Medicine and Critical Care Consultant, King Fahad Specialist Hospital – Dammam, Dammam, Saudi Arabia

[8 ]GRID grid.449795.2, ISNI 0000 0001 2193 453X, School of Medicine, , Francisco de Vitoria University, ; Madrid, Spain

[9 ]GRID grid.254567.7, ISNI 0000 0000 9075 106X, University of South Carolina School of Medicine, ; Columbia, SC USA

[10 ]Anesthesia and Intensive Care, Fondazione IRCCS Policlinico San Matteo, Università Degli Studi Di Pavia, Pavia, Italy

[11 ]GRID grid.443867.a, ISNI 0000 0000 9149 4843, University Hospitals Cleveland Medical Center, ; Cleveland, OH USA

[12 ]GRID grid.414336.7, ISNI 0000 0001 0407 1584, Service D’Anesthésie Réanimation Hôpital Nord, APHM, ; Chemin des Bourrely, 13015 Marseille, France

[13 ]Department of Teaching and Research, Hospital “Dr. Emilio Ferreyra”, Necochea, Argentina

[14 ]GRID grid.22072.35, ISNI 0000 0004 1936 7697, Division of General Internal Medicine, Department of Medicine, , University of Calgary, ; Calgary, Canada

[15 ]GRID grid.412516.5, ISNI 0000 0004 0621 7139, Emergency and Trauma Department, , Hospital Kuala Lumpur, ; 50586 Kuala Lumpur, Malaysia

[16 ]GRID grid.416641.0, ISNI 0000 0004 0607 2419, King Abdulaziz Medical City, King Abdullah International Medical Research Center, , Ministry of National Guard Health Affairs, ; Riyadh, Saudi Arabia

[17 ]GRID grid.412149.b, ISNI 0000 0004 0608 0662, College of Public Health and Health Informatics, , King Saud Bin Abdulaziz University for Health Sciences, ; Riyadh, Saudi Arabia

[18 ]GRID grid.4491.8, ISNI 0000 0004 1937 116X, Dept of Anaesthesiology and Intensive Care, First Medical Faculty, , Charles University, ; Prague, Czechia

[19 ]GRID grid.476880.5, ISNI 0000 0004 0474 3936, Médico Ecografista IADT, ; Buenos Aires, Argentina

[20 ]GRID grid.150338.c, ISNI 0000 0001 0721 9812, Intensive Care Division, , Geneva University Hospitals, ; Geneva, Switzerland

[21 ]GRID grid.31151.37, Department of Anaesthesiology and Intensive Care, , C.H.U. Dijon and Université Bourgogne Franche-Comté, ; LNC UMR866, 21000 Dijon, France

[22 ]GRID grid.413361.2, PICU Hospital San Juan de Dios, ; Santiago, Chile

[23 ]FOM University of Economy & Management, Frankfurt Campus, Frankfurt, Germany

[24 ]GRID grid.419157.f, ISNI 0000 0001 1091 9430, Hospital General, Instituto Mexicano del Seguro Social, ; De Zona 4 Monterrey, Nuevo Leon, Mexico

[25 ]Great North Trauma and Emergency Care Newcastle, Newcastle upon Tyne, UK

[26 ]GRID grid.415199.1, ISNI 0000 0004 1756 8284, Emergency Department, , Latisana General Hospital, ; Latisana, Italy

[27 ]GRID grid.5395.a, ISNI 0000 0004 1757 3729, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, , University of Pisa, ; Pisa, Italy

[28 ]GRID grid.25879.31, ISNI 0000 0004 1936 8972, University of Pennsylvania, ; Philadelphia, PA USA

[29 ]GRID grid.482476.b, ISNI 0000 0000 8995 9090, Montreal Heart Institute, ; Montreal, Canada

[30 ]GRID grid.429252.a, ISNI 0000 0004 1764 4857, Medanta, The Medicity, ; Gurgaon, India

[31 ]GRID grid.416200.1, Ospedale Niguarda C’ Grande, ; Milan, Italy

[32 ]GRID grid.413128.d, ISNI 0000 0004 0647 7221, Dept. of Emergency Medicine, , Bundang Jesaeng Hospital, ; Seoul, Korea

[33 ]WINFOCUS Argentina BOD, Rosario, Argentina

[34 ]GRID grid.410804.9, ISNI 0000000123090000, Department of Clinical Laboratory Medicine and Department of Emergency Medicine, , Jichi Medical University, ; Tokyo, Japan

[35 ]GRID grid.5288.7, ISNI 0000 0000 9758 5690, Oregon Health and Science University, ; Portland, OR USA

[36 ]Department of Respiratory Medicine, Department of Clinical Research, Odense University Hospital, University of Southern Denmark, Odense, Denmark

[37 ]GRID grid.415203.1, ISNI 0000 0004 0451 6370, Khoo Teck Puat Hospital, ; Singapore, Singapore

[38 ]GRID grid.47100.32, ISNI 0000000419368710, Dept. of Emergency Medicine, , Yale School of Medicine, ; New Haven, CT USA

[39 ]GRID grid.411339.d, ISNI 0000 0000 8517 9062, Herzzentrum Leipzig, ; Leipzig, Germany

[40 ]GRID grid.414463.0, ISNI 0000 0004 0638 1756, Department of Ultrasound & Doppler Hospital de Emergencias “Dr. Clemente Alvarez”, ; Rosario, Santa Fe, Argentina

[41 ]GRID grid.24704.35, ISNI 0000 0004 1759 9494, Department of Emergency Medicine, , Careggi University Hospital, ; Firenze, Italia

[42 ]GRID grid.59734.3c, ISNI 0000 0001 0670 2351, Department of Emergency Medicine, , Icahn School of Medicine At Mount Sinai, ; New York, NY USA

[43 ]GRID grid.7149.b, ISNI 0000 0001 2166 9385, Clinical Hospital Zemun, Faculty of Medicine, , University of Belgrade, ; Belgrade, Serbia

[44 ]GRID grid.15043.33, ISNI 0000 0001 2163 1432, Faculty of Medecine, , University of Lleida, ; Lleida, Spain

[45 ]Hospital Raja Permaisuri Bainun, Ipoh, Perak, Malaysia

[46 ]FAME - Medicine School of Barbacena - MG-Brasil, Barbacena, Brazil

[47 ]Arbo Education, Rio de Janeiro, Brazil

[48 ]GRID grid.413780.9, ISNI 0000 0000 8715 2621, SAMU 93 - Hôpital Avicenne, ; Paris, France

[49 ]GRID grid.7605.4, ISNI 0000 0001 2336 6580, Città Della Salute E Della Scienza Di Torino Hospital, , University of Turin, ; Turin, Italy

[50 ]GRID grid.411326.3, ISNI 0000 0004 0626 3362, Faculty of Medicine and Pharmacy VUB, , Univ Hospital Brussels, ; Brussels, Belgium

[51 ]GRID grid.439338.6, ISNI 0000 0001 1114 4366, Royal Brompton Hospital, ; London, UK

[52 ]GRID grid.412415.7, ISNI 0000 0001 0685 1285, Emergency Department, , University Clinical Centre Maribor, ; Maribor, Slovenia

[53 ]Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru

[54 ]Santa Cabrini Hospital, Montreal, Canada

[55 ]GRID grid.1008.9, ISNI 0000 0001 2179 088X, Department of Surgery, , The University of Melbourne, ; Melbourne, VIC Australia

[56 ]GRID grid.239578.2, ISNI 0000 0001 0675 4725, Outcomes Research Consortium, Cleveland Clinic, ; Cleveland, OH USA

[57 ]GRID grid.81821.32, ISNI 0000 0000 8970 9163, Department of Emergency Medicine, , Hospital Universitario La Paz, ; Madrid, Spain

[58 ]GRID grid.11951.3d, ISNI 0000 0004 1937 1135, Division of Emergency Medicine, , University of the Witwatersrand, ; Johannesburg, South Africa

[59 ]GRID grid.46699.34, ISNI 0000 0004 0391 9020, King’s College Hospital, ; London, UK

[60 ]Department of Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730 China

[61 ]GRID grid.233520.5, ISNI 0000 0004 1761 4404, The Fourth Military Medical University, ; Xi’an, 710032 China

[62 ]GRID grid.412149.b, ISNI 0000 0004 0608 0662, King Abdulaziz Medical City, , King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, ; Riyadh, Saudi Arabia

Author information

Arif Hussain http://orcid.org/0000-0002-4143-0475

Article

Publisher ID: 3369

DOI: 10.1186/s13054-020-03369-5

PMC ID: 7759024

PubMed ID: 33357240

SO-VID: fc7f0374-40e1-40de-aa5d-54d934424ca5

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 29 April 2020

Date accepted : 3 November 2020

Custom metadata

ScienceOpen disciplines: Emergency medicine & Trauma

Keywords: covid-19,sars-cov-2,point-of-care ultrasound (pocus),focused cardiac ultrasound (focus),lung ultrasound (lus),echocardiography

Data availability:

ScienceOpen disciplines: Emergency medicine & Trauma

Keywords: covid-19, sars-cov-2, point-of-care ultrasound (pocus), focused cardiac ultrasound (focus), lung ultrasound (lus), echocardiography

Multi-organ point-of-care ultrasound for COVID-19 (PoCUS4COVID): international expert consensus

Read this article at

Abstract

Related collections

Novel Coronavirus Disease COVID-19

Most cited references 94

Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

COVID-19 and Cardiovascular Disease

Author and article information

Contributors

Journal

Affiliations

Author information

Article

History

Categories

Custom metadata

Comments

Comment on this article

Similar content 176

Cited by 55