Lung Ultrasound Findings in Patients With COVID-19 in a UK ED

NCT05065827 | Completed

• 2 other identifiers: C&W20/050IRAS number 286642
• Study Type: observational
• Target: 43
• Locations: 1 country
• Sites: 1

Brief Summary

The investigators aim to carry out a retrospective observational study, analysing lung ultrasound images from patients who have presented to A\&E for routine diagnostic purposes (ruling out cardiogenic pulmonary oedema, Pulmonary embolism and pericardial effusions) and systematically assessing for abnormalities typical for COVID-19 infection (Pleural irregularities, B lines, consolidations, pleural effusions). Doing this, the investigators will also develop a suggestion for a standardised technique for lung ultrasound which can be transferred to other clinical settings (Intensive Care, Acute medical Unit) and could form the basis for an international standard. Thirdly, the investigators aim to correlate our findings to clinical severity judged by oxygenation status on arrival in ED. To the investigators' knowledge, this is the first study of this kind.

Conditions

Covid19; Coronavirus; Corona Virus Infection; SARS-CoV Infection

Keywords

COVID-19; Lung ultrasound; Retrospective

Outcome Measures

Primary Outcomes (1)

• Characterisation of lung changes in COVID-19 patients as seen on ultrasound

  Retrospective scoring of lung ultrasound images (12-zone ultrasound where clinical status allowed) for each of 5 lung abnormalities (pleural irregularity, B lines, small peripheral consolidation, large consolidation, small effusion (\<1cm) and large effusion (\>1cm). The images will be scored by 2 independent observers and the scores will be analysed based on the occurrence, location within the lung and clinical correlation

  2-3 months

Secondary Outcomes (1)

• Correlation of lung changes as seen on ultrasound with clinical severity as per the Berlin ARDS criteria

  2-3 months

Study Arms (4)

Normal oxygenation

Normal oxygenation based on the BERLIN criteria for ARDS

Mild deficit in oxygenation

Mild deficit in oxygenation based on the BERLIN criteria for ARDS

Moderate deficit in oxygenation

Moderate deficit in oxygenation based on the BERLIN criteria for ARDS

Severe deficit in oxygenation

Severe deficit in oxygenation based on the BERLIN criteria for ARDS

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Adult patients with COVID-19 viral infection.

You may qualify if:

• Presented to the ED between March-May 2020 with dyspnoea
• COVID-19 positive either by PCR test or composite diagnostic criteria of lymphopenia and positive Chest XR report
• Received lung ultrasound as part of investigations during ED attendance

You may not qualify if:

• \< 18 years of age
• Not diagnosed with COVID-19

Sponsors & Collaborators

• Chelsea and Westminster NHS Foundation Trust: lead

Study Sites (1)

Chelsea and Westminster Hospital

London, Greater London, SW10 9NH, United Kingdom

Location

Related Publications (11)

• Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020 Feb 15;395(10223):497-506. doi: 10.1016/S0140-6736(20)30183-5. Epub 2020 Jan 24.

  PMID: 31986264 BACKGROUND

• Lichtenstein D, Meziere G, Biderman P, Gepner A, Barre O. The comet-tail artifact. An ultrasound sign of alveolar-interstitial syndrome. Am J Respir Crit Care Med. 1997 Nov;156(5):1640-6. doi: 10.1164/ajrccm.156.5.96-07096.

  PMID: 9372688 BACKGROUND

• Lichtenstein D. Lung ultrasound in the critically ill. Curr Opin Crit Care. 2014 Jun;20(3):315-22. doi: 10.1097/MCC.0000000000000096.

  PMID: 24758984 BACKGROUND

• Lichtenstein DA. Current Misconceptions in Lung Ultrasound: A Short Guide for Experts. Chest. 2019 Jul;156(1):21-25. doi: 10.1016/j.chest.2019.02.332. Epub 2019 Mar 11. No abstract available.

  PMID: 30872018 BACKGROUND

• Soldati G, Smargiassi A, Inchingolo R, Buonsenso D, Perrone T, Briganti DF, Perlini S, Torri E, Mariani A, Mossolani EE, Tursi F, Mento F, Demi L. On Lung Ultrasound Patterns Specificity in the Management of COVID-19 Patients. J Ultrasound Med. 2020 Nov;39(11):2283-2284. doi: 10.1002/jum.15326. Epub 2020 May 8. No abstract available.

  PMID: 32383781 BACKGROUND

• Vetrugno L, Bove T, Orso D, Barbariol F, Bassi F, Boero E, Ferrari G, Kong R. Our Italian experience using lung ultrasound for identification, grading and serial follow-up of severity of lung involvement for management of patients with COVID-19. Echocardiography. 2020 Apr;37(4):625-627. doi: 10.1111/echo.14664. Epub 2020 Apr 15.

  PMID: 32239532 BACKGROUND

• Volpicelli G, Gargani L. Sonographic signs and patterns of COVID-19 pneumonia. Ultrasound J. 2020 Apr 21;12(1):22. doi: 10.1186/s13089-020-00171-w.

  PMID: 32318891 BACKGROUND

• Xing C, Li Q, Du H, Kang W, Lian J, Yuan L. Lung ultrasound findings in patients with COVID-19 pneumonia. Crit Care. 2020 Apr 28;24(1):174. doi: 10.1186/s13054-020-02876-9. No abstract available.

  PMID: 32345353 BACKGROUND

• Yasukawa K, Minami T. Point-of-Care Lung Ultrasound Findings in Patients with COVID-19 Pneumonia. Am J Trop Med Hyg. 2020 Jun;102(6):1198-1202. doi: 10.4269/ajtmh.20-0280.

  PMID: 32333544 BACKGROUND

• Soldati G, Smargiassi A, Inchingolo R, Buonsenso D, Perrone T, Briganti DF, Perlini S, Torri E, Mariani A, Mossolani EE, Tursi F, Mento F, Demi L. Proposal for International Standardization of the Use of Lung Ultrasound for Patients With COVID-19: A Simple, Quantitative, Reproducible Method. J Ultrasound Med. 2020 Jul;39(7):1413-1419. doi: 10.1002/jum.15285. Epub 2020 Apr 13.

  PMID: 32227492 BACKGROUND

• Ferguson ND, Fan E, Camporota L, Antonelli M, Anzueto A, Beale R, Brochard L, Brower R, Esteban A, Gattinoni L, Rhodes A, Slutsky AS, Vincent JL, Rubenfeld GD, Thompson BT, Ranieri VM. The Berlin definition of ARDS: an expanded rationale, justification, and supplementary material. Intensive Care Med. 2012 Oct;38(10):1573-82. doi: 10.1007/s00134-012-2682-1. Epub 2012 Aug 25.

  PMID: 22926653 BACKGROUND

MeSH Terms

Conditions

COVID-19; Coronavirus Infections; Severe Acute Respiratory Syndrome

Condition Hierarchy (Ancestors)

Pneumonia, Viral; Pneumonia; Respiratory Tract Infections; Infections; Virus Diseases; Coronaviridae Infections; Nidovirales Infections; RNA Virus Infections; Lung Diseases; Respiratory Tract Diseases

Study Officials

• Paramjeet Deol, MBChB FRCEM

  paramjeet.deol@chelwest.nhs.uk

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 30, 2021
• First Posted: October 4, 2021
• Study Start: September 29, 2020
• Primary Completion: December 12, 2020
• Study Completion: December 12, 2020
• Last Updated: October 22, 2021

Record last verified: 2021-10

Data Sharing

• IPD Sharing: Will not share

Locations

GB (1)