الفهرس 
COVID-19Only 14 pages are availabe for public view
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Abstract
COVID-19 is a highly contagious illness caused by the severe acute
respiratory syndrome coronavirus 2 (SARS-CoV-2). The main diagnostic
method, (RT-PCR) of the nucleic acid of SARS-CoV-2, has many
limitations, such as low sensitivity and technical difficulties in performing
the test.
(CT) scan reveals with higher sensitivity ground glass opacities
(GGOs), however the use of chest CT remains very limited in the critically
ill as the transport of unstable patients and exposure of infected patients
may also outweigh the clinical benefit.
On the other hand ultrasound machines are widely available;
therefore, LUS can be performed in few minutes, in mild or even unstable
patients and in different hospital settings, and we aimed to evaluate the role
of LUS in follow up of patients with COVID 19 in relation to clinical and
laboratory data .
Summary of our results:
This study included 116 Covid-19 patients (62 males and 54
females) in need of oxygen therapy or non-invasive ventilation with a
median age of 59 years (range from 23 to 85).
All the studied patients presented with cough and dyspnea, while
56%, 47.4%, 38.8%, 20.7% and 2.6% of whom had cough and dyspnea
after 3, 6, 9, 12 and 15 days, respectively.
Also, all patients had fever on admission while 56%, 34.5%, 21.6%,
14.7% and 0.9% of whom elicited fever after 3, 6, 9, 12 and 15 days,
respectively. Moreover, 47.4% of patients showed GIT symptoms on admission, and that percentage was dropped to 21.6%, 4.3% and 0% after
3, 6 and 9 days
All 116 patients elicited interstitial syndrome, of whom, 89.5%
showed confluent B-lines (unilateral in 6.3% of patients and bilateral in
93.8%) and 12.5% showed focal B-lines. The confluent B-lines were most
frequently distributed in posterolateral zone (31.6% of the affected zones)
followed by lateral zone (19.1%). Subpleural consolidations were elicited
by 70.8% of patients, unilaterally in 22.9% and bilaterally in 47.9%,
moreover, they were distributed predominantly in posterolateral zone
(43.6% of affected zones) and posteroinferior zone (22.3%).
One third of patients elicited alveolar consolidations with
bronchogram, detected unilaterally in 25% of patients and bilaterally in
8.3%, moreover, they were distributed predominantly in posterolateral zone
(56.3% of affected zones) and posteroinferior zone (25%.). Only 2.1% of
patients had Pleural effusion detected unilaterally
On admission, non-invasive MV was the most predominant method
of oxygenation (in 42.2% of patients) followed by high flow nasal cannula
(31.9%) then non rebreathing mask (17.2%). After 3 days, more than half
of patients (58.6%) were on non-invasive MV and around one third
(33.6%) were on high flow nasal cannula. After 6 days, the most frequently
used method was high flow nasal cannula (in 43.1% of patients) then noninvasive MV (29.3%). After 9 and 12 days, high flow nasal cannula was
used in 49.1% and 29.3% of patients respectively while invasive MV was
applied to 36.2% and 28.4% respectively. Moreover, 7.8% of patients were
on high flow nasal cannula after 15 days
There was a statistically significant difference among timepoints
regarding FiO2, SpO2 and P/F measurements as FiO2 was significantly decreased after 9, 12 and 15 days than baseline while both SpO2 and P/F
were significantly increased after 9, 12 and 15 days than baseline
37.9% of patients had moderate Covid-19 and 62.1% had severe
diagnosis on admission with a median LUS score of 19 (IQR between 17
and 20). After 3 days, 42.2% manifested moderate disease and 57.8% had
severe disease with a median LUS score of 19 (IQR between 16 and 21).
After 6 days, more than half of patients (58.6%) showed moderate disease
and 41.4% had severe diagnosis, with a median LUS score of 17 (IQR
between 12 and 23). After 9 days, 27.6%, 31% and 41.4% of patients had
mild, moderate and severe diagnosis, respectively, with a median LUS
score of 14 (IQR between 7 and 26). After 12 days, 21.6%, 9.5% and
28.4% showed mild, moderate and severe disease, respectively, with a
median LUS score of 14 (IQR between 7 and 30). After 15 days, 4.3% of
patients showed mild disease and 3.4% showed moderate disease with a
median score of 7 (IQR between 6 and 13). LUS score was significantly
different among timepoints (P<0.001) as it was significantly decreased
(indicating less severe diagnosis) after 9, 12 and 15 days when compared to
its value on admission.