Prognostic Value of Lung Ultrasonography in Older Nursing Home Residents Affected by COVID-19.
Aged
Aged, 80 and over
Betacoronavirus
COVID-19
COVID-19 Testing
Clinical Laboratory Techniques
Coronavirus Infections
/ diagnosis
Female
Humans
Lung
/ diagnostic imaging
Male
Nursing Homes
/ organization & administration
Pandemics
Pneumonia, Viral
/ diagnostic imaging
Retrospective Studies
SARS-CoV-2
Ultrasonography
COVID-19
Ultrasonography
lung
nursing home
Journal
Journal of the American Medical Directors Association
ISSN: 1538-9375
Titre abrégé: J Am Med Dir Assoc
Pays: United States
ID NLM: 100893243
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
09
06
2020
revised:
23
07
2020
accepted:
24
07
2020
pubmed:
5
9
2020
medline:
7
10
2020
entrez:
5
9
2020
Statut:
ppublish
Résumé
Lung ultrasonographic (LUS) imaging may play an important role in the management of patients with COVID-19-associated lung injury, particularly in some special populations. However, data regarding the prognostic role of the LUS in nursing home residents, one of the populations most affected by COVID-19, are not still available. Retrospective. Nursing home residents affected by COVID-19 were followed up with an LUS from April 8 to May 14, 2020, in Chioggia, Venice. COVID-19 was diagnosed through a nasopharyngeal swab. LUS results were scored using a 12-zone method. For each of the 12 zones (2 posterior, 2 anterior, 2 lateral, for both left and right lungs), the possible score ranged from 0 to 3 (1 = presence of B lines, separated, with <50% of space from the pleural line; 2 = presence of B lines, separated, with >50% of space from the pleural line; 3 = lung thickening with tissuelike aspect). The total score ranged from 0 to 36. Mortality was assessed using administrative data. Data regarding accuracy (and related parameters) were reported. Among 175 nursing home residents, 48 (mean age: 84.1 years; mainly female) were affected by COVID-19. Twelve died during the follow-up period. The mean LUS score was 3. The area under the curve of LUS in predicting mortality was 0.603 [95% confidence interval (CI): 0.419-0.787], and it increased to 0.725 (95% CI: 0.41-0.99) after including follow-up LUS controls. Taking an LUS score ≥4 as exposure variable and mortality as outcome, the sensitivity was 58.33% and specificity 63.89%, with a positive likelihood ratio of 1.62 and a negative of 0.65. LUS is able to significantly predict mortality in nursing home residents affected by COVID-19, suggesting that this simple tool can be routinely used in this setting instead of more invasive techniques available only in hospital.
Identifiants
pubmed: 32883596
pii: S1525-8610(20)30659-9
doi: 10.1016/j.jamda.2020.07.034
pmc: PMC7388855
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1384-1386Informations de copyright
Copyright © 2020 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
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