Predicting Outcomes for Covid-19 Using Sonography

Completed

Brief Summary: This study seeks to investigate the role of lung ultrasound in caring for Covid-19 positive patients and whether it can be used to predict patient deterioration. This information will be vital for healthcare workers who seek to identify Covid-19 pneumonia or patients at risk for deterioration early in the disease course.

Detailed Description: As Covid-19 continues to stress hospital-based resources (including personal protective equipment, ancillary staff availability, and imaging study utilization), it is important to assess whether alternative methods for evaluating patients can be utilized to appropriately triage and care for Covid-positive patients. Current limitations of caring for patients with Covid-19 include the exposure of ancillary healthcare workers (including radiological technicians) and the time/resources required to decontaminate traditional radiological equipment such as x-ray or computerized tomography (CT) machines.

Point-of-care ultrasound (POCUS) has the potential to transform healthcare delivery due to its diagnostic and therapeutic expediency. It can be quickly performed at the bedside by experienced clinicians. It it has been shown to reliably and accurately diagnose patients with a variety of lung diseases, including pneumonia. This study seeks to investigate the role of lung ultrasound in caring for Covid-19 positive patients and whether it can be used to predict patient deterioration. This information will be vital for healthcare workers who seek to identify the virus or patients at risk for deterioration early in the disease course. Moreover, it has the potential to reduce the need for x-rays or CTs for Covid-19 patients, which has the potential to alleviate a significant burden currently being placed on the healthcare system.

Recruitment & Eligibility

Inclusion Criteria

Any adult (18 or more years of age) presenting to the emergency department with symptoms suspicious for Covid-19
This individual underwent evaluation for Covid-19 via a nasopharyngeal RT-PCR
This individual received a lung ultrasound by the study authors within 28 days from initial evaluation

Exclusion Criteria

Any individual who did not receive a lung ultrasound within 28 days from initial evaluation for covid-19 related illness

Arm && Interventions

Group	Intervention	Description
Covid-19 Positive Patients	Lung Ultrasound	This group includes individuals who were diagnosed with Covid-19 based on reverse transcriptase polymerase chain reaction (RT-PCR) of the nasopharynx
Covid-19 Negative Patients	Lung Ultrasound	This group includes individuals who did NOT have a positive test for Covid-19 based on reverse transcriptase polymerase chain reaction (RT-PCR) of the nasopharynx.

Primary Outcome Measures

Name	Time	Method
Number of Patients Experiencing Death, ICU Admission, Mechanical Ventilation, or Use of High-Flow Nasal Cannula	28 days from initial evaluation	Composite primary outcome of death, ICU admission, mechanical ventilation, or use of high-flow nasal cannula (categorical)

Secondary Outcome Measures

Name	Time	Method
Number of Patients Requiring Mechanical Ventilation	28 days from initial evaluation
Length of Stay	28 days from initial evaluation	Duration of Hospitalization (days)
Characterization of Ultrasound Findings	28 days from initial evaluation	Descriptive analysis of ultrasound findings in Covid-19
Number of Patients Requiring Supplemental Oxygen Usage	28 days from initial evaluation
Duration of Supplemental Oxygen Usage	28 days from initial evaluation

Locations (2): University of California San Francisco
🇺🇸
San Francisco, California, United States
Stanford University
🇺🇸
Stanford, California, United States

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