Abstract
Background: The majority of patients with SARS-CoV-2 infection are diagnosed and managed as outpatients; however, little is known about the burden of pulmonary disease in this setting. Lung ultrasound (LUS) is a convenient tool for detection of COVID-19 pneumonia. Identifying SARS-CoV-2 infected outpatients with pulmonary disease may be important for early risk stratification.
Objectives: To investigate the prevalence, natural history and clinical significance of pulmonary disease in outpatients with SARS-CoV-2.
Methods: SARS-CoV-2 PCR positive outpatients (CV(+)) were assessed with LUS to identify the presence of interstitial pneumonia. Studies were considered positive based on the presence of B-lines, pleural irregularity and consolidations. A subset of patients underwent longitudinal examinations. Correlations between LUS findings and patient symptoms, demographics, comorbidities and clinical outcomes over 8 weeks were evaluated.
Results: 102 CV(+) patients underwent LUS with 42 (41%) demonstrating pulmonary involvement. Baseline LUS severity scores correlated with shortness of breath on multivariate analysis. Of the CV(+) patients followed longitudinally, a majority showed improvement or resolution in LUS findings after 1-2 weeks. Only one patient in the CV(+) cohort was briefly hospitalised, and no patient died or required mechanical ventilation.
Conclusion: We found a high prevalence of LUS findings in outpatients with SARS-CoV-2 infection. Given the pervasiveness of pulmonary disease across a broad spectrum of LUS severity scores and lack of adverse outcomes, our findings suggest that LUS may not be a useful as a risk stratification tool in SARS-CoV-2 in the general outpatient population.
Keywords: COVID-19; imaging/CT MRI etc; pneumonia.
【저자키워드】 COVID-19, Pneumonia, imaging/CT MRI etc, 【초록키워드】 SARS-CoV-2, COVID-19 pneumonia, mechanical ventilation, Pneumonia, SARS-COV-2 infection, Infection, Comorbidities, Comorbidity, MRI, clinical outcomes, adverse outcomes, Clinical outcome, Prevalence, risk stratification, Cohort, Severity Score, Patient, Clinical significance, outpatients, interstitial pneumonia, pulmonary disease, Multivariate analysis, Outpatient, broad spectrum, Analysis, SARS-CoV-2 PCR, demographics, natural history, Shortness of breath, consolidations, pulmonary involvement, correlations, Patient symptoms, positive, identifying, hospitalised, identify, lack, died, diagnosed, evaluated, required, majority, correlated, subset, patients with SARS-CoV-2, were assessed, 【제목키워드】 lung, Outpatient,