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

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • Kristoffer Grundtvig Skaarup
  • Mats Christian Hojbjerg Lassen
  • Caroline Espersen
  • Jannie Norgaard Lind
  • Niklas Dyrby Johansen
  • Morten Sengelov
  • Alia Saed Alhakak
  • Anne Bjerg Nielsen
  • Kirstine Ravnkilde
  • Raphael Hauser
  • Liv Borum Schops
  • Eva Holt
  • Reza Jabbari
  • Uffe Bodtger
  • Matias Greve Lindholm
  • Lothar Wiese
  • Ole Peter Kristiansen
  • Emil Schwarz Walsted
  • Niels Tonder
  • Klaus Nielsen Jeschke
  • Pradeesh Sivapalan
  • Jannik Pallisgaard
  • Soren Helbo Skaarup
  • Elke Platz

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. Clinicaltrials.gov ID NCT04377035

OriginalsprogEngelsk
TidsskriftJournal of Ultrasound
Antal sider11
ISSN1971-3495
DOI
StatusE-pub ahead of print - 2 jul. 2021

ID: 274065337