Correlation of Lung Ultrasonography With Chest CT Findings in Cancer Patients With COVID-19 Viral Pneumonia

NCT05279378 | Completed DMC

• 1 other identifier: IORG0006563
• Study Type: observational
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

Thoracic imaging, either with chest X-ray (CXR) or computed tomography (CT), is an essential part of the diagnosis of coronavirus disease-19 (COVID-19) in patients admitted to hospital with fever or respiratory symptoms. Inspite of the results of PCR tests are the gold standard, the sensitivity of CT for diagnosing COVID-19 is 97%. The specific epidemic contingency makes CT an accurate tool to stratify patients based on imaging patterns, predicting poor outcomes and the need for ventilation. Lung ultrasound (LUS) is widely used in emergency departments because it is broadly available, low-cost, and has a high accuracy for diagnosing pulmonary diseases. Despite the diagnostic power of LUS and its influence on decision-making and therapeutic management, there are still significant barriers to the widespread use of this tool. The advantages of LUS are more obvious in older patients with multimorbidity and restricted mobility, for whom high-quality CXR and CT scans are difficult to obtain. In the hands of experienced clinicians, LUS diagnostic accuracy for bacterial pneumonia is similar to chest CT. However, a correlation between LUS and CT findings in patient urgently hospitalized for severe COVID-19 pneumonia remains to be determined. COVID-19 leads to an aggressive inflammatory response that is actually the reaction of the immune system. Some patients exhibit pneumonia in both lungs, multi-organ failure, and even death. Individuals who have severe health conditions, like cancer, cardiovascular diseases, diabetes, and pulmonary diseases, are at higher risk of COVID-19 infection. Also, this dysregulated immune response resulting in excessive production of inflammatory cytokines and chemokines (as IL-1ra, IL-6, IP-10, G-CSF, MCP-1, MIP-1α and TNF) causes the development of cytokine release syndrome (CRS) which is considered as pathologic underpinning for disease progression and lead to severe collateral tissue damage. IL-6 may serve as a predictive biomarker for disease severity as its elevated levels were reported in several studies of COVID-19 infection. Also IL-6 levels were correlated with mortality in COVID-19 patients. IL-6 blockade is a promising strategy for COVID-induced CRS. In particular, clinical epidemiological studies are needed to determine if IL-6 and/or other inflammatory cytokine levels predict subsequent development and persistence of long COVID 19 viral pneumonia.

Conditions

Cancer Patients

Outcome Measures

Primary Outcomes (1)

• comparing the CT versus LUS findings

  comparing the CT versus LUS findings in cancer patients with moderate and severe COVID-19 viral pneumonia who will be admitted to our hospital and to correlate these findings with clinical features

  2 weeks

Secondary Outcomes (1)

• correlation of the results with the level of IL-6

  within 2 weeks

Interventions

lung ultrasonography versus CT RADIATION

chest CT will be done before admission and LUS within first 24 h from admission into the quarantine sector. In addition to 2 weeks after admission. CT images will be reviewed by chest radiologist expert, who will calculate a CT severity score based on extension and distribution of GGOs and consolidations. All CT scans will be performed in supine position at end inspiration without intravenous administration of contrast media. Within 24 h from admission and CT scanning, bedside LUS will be performed by clinician who will be blind to chest CT findings. Examinations will be performed with the patient in the sitting position, systematically scanning the front and the back side of each hemithorax. Blood sample will be collected into 4 mL Vacuette containing EDTA. Samples will be stored on ice, processed within 30 min and plasma will be isolated by centrifugation at 2000g for 20 min at 4 °C. Plasma will be immediately frozen at - 80 °C in several aliquots.

Eligibility Criteria

• Age: 16 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)
• Sampling Method: Non-Probability Sample

Study Population

Cancer patients admitted to South Egypt Cancer Institute (SECI), Asyut University, Egypt with COVID-19 viral pneumonia in the period from March 2022 to December 2023, with ages ranging from 18 to 60 years old, of male or female gender, and CT Chest findings of CORAD 4, 5 and 6 with moderate and severe symptoms.

You may qualify if:

• The study population will include cancer patients admitted to South Egypt Cancer Institute (SECI), Asyut University, Egypt with COVID-19 viral pneumonia in the period from March 2022 to December 2023, with ages ranging from 18 to 60 years old, of male or female gender, and CT Chest findings of CORAD 4, 5 and 6 with moderate and severe symptoms.
• All cancer patients are diagnosed COVID-19 by PCR from a nasopharyngeal swab.

Sponsors & Collaborators

• South Egypt Cancer Institute: lead

Study Sites (1)

South Egypt cancei institute

Asyut, Egypt

Location

Related Publications (24)

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Related Links

• Diagnostic Performance of CT and Reverse Transcriptase Polymerase Chain Reaction for Coronavirus Disease 2019: A Meta-Analysis
• Correlation of Chest CT and RT-PCR Testing for Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases
• Well-aerated Lung on Admitting Chest CT to Predict Adverse Outcome in COVID-19 Pneumonia.
• The risk of cumulative radiation exposure in chest imaging and the advantage of bedside ultrasound
• The risk of cumulative radiation exposure in chest imaging and the advantage of bedside ultrasound
• Lung ultrasound score predicts outcomes in COVID-19 patients admitted to the emergency department
• Lung ultrasound in the intensive care unit: let's move forward
• Lung Ultrasound in COVID-19 Pneumonia: Correlations with Chest CT on Hospital admission
• The Geriatric Patient: The Ideal One for Chest Ultrasonography? A Review From the Chest Ultrasound in the Elderly Study Group (GRETA) of the Italian Society of Gerontology and Geriatrics (SIGG)
• Thoracic ultrasound for the diagnosis of pneumonia in adults: A meta-analysis
• Understanding SARS-CoV-2-Mediated Inflammatory Responses: From Mechanisms to Potential Therapeutic Tools
• CT quantification of pneumonia lesions in early days predicts progression to severe illness in a cohort of COVID-19 patients
• COVID-19 and cardiovascular disease: from basic mechanisms to clinical perspectives
• Related Info
• Patients with Cancer Appear More Vulnerable to SARS-CoV-2: A Multicenter Study during the COVID-19 Outbreak
• Clinical characteristics of coronavirus disease 2019 in Gansu province
• Lung ultrasound score predicts outcomes in COVID-19 patients admitted to the emergency department.
• Lung ultrasound in the intensive care unit: let's move forward
• Lung Ultrasound in COVID-19 Pneumonia: Correlations with Chest CT on Hospital admission

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Target Duration: 2 Weeks
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: assistant lecturer

Study Record Dates

• First Submitted: March 11, 2022
• First Posted: March 15, 2022
• Study Start: March 30, 2022
• Primary Completion: June 30, 2025
• Study Completion: November 28, 2025
• Last Updated: February 18, 2026

Record last verified: 2022-03

Locations

EG (1)