Lung ultrasound findings in hospitalized COVID-19 patients in relation to venous thromboembolic events: the ECHOVID-19 study

Kristoffer Grundtvig Skaarup, Mats Christian Højbjerg Lassen, Caroline Espersen, Jannie Nørgaard Lind, Niklas Dyrby Johansen, Morten Sengeløv, Alia Saed Alhakak, Anne Bjerg Nielsen, Kirstine Ravnkilde, Raphael Hauser, Liv Borum Schöps, Eva Holt, Henning Bundgaard, Christian Hassager, Reza Jabbari, Jørn Carlsen, Ole Kirk, Uffe Bodtger, Matias Greve Lindholm, Lothar WieseOle Peter Kristiansen, Emil Schwarz Walsted, Olav Wendelboe Nielsen, Birgitte Lindegaard, Niels Tønder, Klaus Nielsen Jeschke, Charlotte Suppli Ulrik, Morten Lamberts, Pradeesh Sivapalan, Jannik Pallisgaard, Gunnar Gislason, Kasper Iversen, Jens Ulrik Stæhr Jensen, Morten Schou, Søren Helbo Skaarup, Elke Platz, Tor Biering-Sørensen*

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftArtikelForskningpeer review

Abstract

PURPOSE: Several studies have reported thromboembolic events to be common in severe COVID-19 cases. We sought to investigate the relationship between lung ultrasound (LUS) findings in hospitalized COVID-19 patients and the development of venous thromboembolic events (VTE).

METHODS: A total of 203 adults were included from a COVID-19 ward in this prospective multi-center study (mean age 68.6 years, 56.7% men). All patients underwent 8-zone LUS, and all ultrasound images were analyzed off-line blinded. Several LUS findings were investigated (total number of B-lines, B-line score, and LUS-scores).

RESULTS: Median time from admission to LUS examination was 4 days (IQR: 2, 8). The median number of B-lines was 12 (IQR: 8, 18), and 44 (21.7%) had a positive B-line score. During hospitalization, 17 patients developed VTE (4 deep-vein thrombosis, 15 pulmonary embolism), 12 following and 5 prior to LUS. In fully adjusted multivariable Cox models (excluding participants with VTE prior to LUS), all LUS parameters were significantly associated with VTE (total number of B-lines: HR = 1.14, 95% CI (1.03, 1.26) per 1 B-line increase), positive B-line score: HR = 9.79, 95% CI (1.87, 51.35), and LUS-score: HR = 1.51, 95% CI (1.10, 2.07), per 1-point increase). The B-line score and LUS-score remained significantly associated with VTE in sensitivity analyses.

CONCLUSION: In hospitalized COVID-19 patients, pathological LUS findings were common, and the total number of B-lines, B-line score, and LUS-score were all associated with VTE. These findings indicate that the LUS examination may be useful in risk stratification and the clinical management of COVID-19. These findings should be considered hypothesis generating.

GOV ID: NCT04377035.

OriginalsprogEngelsk
Sider (fra-til)457-467
Antal sider11
TidsskriftJournal of ultrasound
Vol/bind25
Udgave nummer3
Tidlig onlinedato2 jul. 2021
DOI
StatusUdgivet - sep. 2022

Bibliografisk note

© 2021. Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB).

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