TY - JOUR
T1 - Lung ultrasound findings in hospitalized COVID-19 patients in relation to venous thromboembolic events
T2 - the ECHOVID-19 study
AU - Skaarup, Kristoffer Grundtvig
AU - Lassen, Mats Christian Hojbjerg
AU - Espersen, Caroline
AU - Lind, Jannie Norgaard
AU - Johansen, Niklas Dyrby
AU - Sengeløv, Morten
AU - Alhakak, Alia Saed
AU - Nielsen, Anne Bjerg
AU - Ravnkilde, Kirstine
AU - Hauser, Raphael
AU - Schops, Liv Borum
AU - Holt, Eva
AU - Bundgaard, Henning
AU - Hassager, Christian
AU - Jabbari, Reza
AU - Carlsen, Jorn
AU - Kirk, Ole
AU - Bodtger, Uffe
AU - Lindholm, Matias Greve
AU - Wiese, Lothar
AU - Kristiansen, Ole Peter
AU - Walsted, Emil Schwarz
AU - Nielsen, Olav Wendelboe
AU - Lindegaard, Birgitte
AU - Tonder, Niels
AU - Jeschke, Klaus Nielsen
AU - Ulrik, Charlotte Suppli
AU - Lamberts, Morten
AU - Sivapalan, Pradeesh
AU - Pallisgaard, Jannik
AU - Gislason, Gunnar
AU - Iversen, Kasper
AU - Jensen, Jens Ulrik Staehr
AU - Schou, Morten
AU - Skaarup, Soren Helbo
AU - Platz, Elke
AU - Biering-Sorensen, Tor
PY - 2022
Y1 - 2022
N2 - Purpose Several studies have reported thromboembolic events to be common in severe COVID-19 cases. We sought to investigate the relationship between lung ultrasound (LUS) findings in hospitalized COVID-19 patients and the development of venous thromboembolic events (VTE). Methods A total of 203 adults were included from a COVID-19 ward in this prospective multi-center study (mean age 68.6 years, 56.7% men). All patients underwent 8-zone LUS, and all ultrasound images were analyzed off-line blinded. Several LUS findings were investigated (total number of B-lines, B-line score, and LUS-scores). Results Median time from admission to LUS examination was 4 days (IQR: 2, 8). The median number of B-lines was 12 (IQR: 8, 18), and 44 (21.7%) had a positive B-line score. During hospitalization, 17 patients developed VTE (4 deep-vein thrombosis, 15 pulmonary embolism), 12 following and 5 prior to LUS. In fully adjusted multivariable Cox models (excluding participants with VTE prior to LUS), all LUS parameters were significantly associated with VTE (total number of B-lines: HR = 1.14, 95% CI (1.03, 1.26) per 1 B-line increase), positive B-line score: HR = 9.79, 95% CI (1.87, 51.35), and LUS-score: HR = 1.51, 95% CI (1.10, 2.07), per 1-point increase). The B-line score and LUS-score remained significantly associated with VTE in sensitivity analyses. Conclusion In hospitalized COVID-19 patients, pathological LUS findings were common, and the total number of B-lines, B-line score, and LUS-score were all associated with VTE. These findings indicate that the LUS examination may be useful in risk stratification and the clinical management of COVID-19. These findings should be considered hypothesis generating. Clinicaltrials.gov ID NCT04377035
AB - Purpose Several studies have reported thromboembolic events to be common in severe COVID-19 cases. We sought to investigate the relationship between lung ultrasound (LUS) findings in hospitalized COVID-19 patients and the development of venous thromboembolic events (VTE). Methods A total of 203 adults were included from a COVID-19 ward in this prospective multi-center study (mean age 68.6 years, 56.7% men). All patients underwent 8-zone LUS, and all ultrasound images were analyzed off-line blinded. Several LUS findings were investigated (total number of B-lines, B-line score, and LUS-scores). Results Median time from admission to LUS examination was 4 days (IQR: 2, 8). The median number of B-lines was 12 (IQR: 8, 18), and 44 (21.7%) had a positive B-line score. During hospitalization, 17 patients developed VTE (4 deep-vein thrombosis, 15 pulmonary embolism), 12 following and 5 prior to LUS. In fully adjusted multivariable Cox models (excluding participants with VTE prior to LUS), all LUS parameters were significantly associated with VTE (total number of B-lines: HR = 1.14, 95% CI (1.03, 1.26) per 1 B-line increase), positive B-line score: HR = 9.79, 95% CI (1.87, 51.35), and LUS-score: HR = 1.51, 95% CI (1.10, 2.07), per 1-point increase). The B-line score and LUS-score remained significantly associated with VTE in sensitivity analyses. Conclusion In hospitalized COVID-19 patients, pathological LUS findings were common, and the total number of B-lines, B-line score, and LUS-score were all associated with VTE. These findings indicate that the LUS examination may be useful in risk stratification and the clinical management of COVID-19. These findings should be considered hypothesis generating. Clinicaltrials.gov ID NCT04377035
KW - COVID-19
KW - Lung ultrasound
KW - B-lines
KW - Venous thromboembolic events
KW - PULMONARY CONGESTION
KW - DIAGNOSIS
KW - PNEUMONIA
KW - WUHAN
KW - CHINA
U2 - 10.1007/s40477-021-00605-8
DO - 10.1007/s40477-021-00605-8
M3 - Journal article
C2 - 34213740
SN - 1971-3495
VL - 25
SP - 457
EP - 467
JO - Journal of Ultrasound
JF - Journal of Ultrasound
ER -