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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Covid-19 Positive Patients | 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 | 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. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Lung Ultrasound | Diagnostic Test | Lung ultrasound will be performed on patients undergoing investigation for covid-19 based on a nasopharyngeal PCR. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of Patients Experiencing Death, ICU Admission, Mechanical Ventilation, or Use of High-Flow Nasal Cannula | Composite primary outcome of death, ICU admission, mechanical ventilation, or use of high-flow nasal cannula (categorical) | 28 days from initial evaluation |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Patients Requiring Mechanical Ventilation | 28 days from initial evaluation | |
| Number of Patients Requiring Supplemental Oxygen Usage | 28 days from initial evaluation | |
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Inclusion Criteria:
Exclusion Criteria:
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This population will include all persons under investigation (PUIs) for covid-19 presenting to the Stanford emergency department.
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| Name | Affiliation | Role |
|---|---|---|
| Andre D Kumar, MD, MEd | Stanford University | Principal Investigator |
| Sally Graglia, MD, MPH | University of California, San Francisco | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of California San Francisco | San Francisco | California | 94117 | United States | ||
| Stanford University |
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| ID | Term |
|---|---|
| D000086382 | COVID-19 |
| D011024 | Pneumonia, Viral |
| ID | Term |
|---|---|
| D011014 | Pneumonia |
| D012141 | Respiratory Tract Infections |
| D007239 | Infections |
| D014777 | Virus Diseases |
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| Duration of Supplemental Oxygen Usage |
| 28 days from initial evaluation |
| Length of Stay | Duration of Hospitalization (days) | 28 days from initial evaluation |
| Characterization of Ultrasound Findings | Descriptive analysis of ultrasound findings in Covid-19 | 28 days from initial evaluation |
| Stanford |
| California |
| 95401 |
| United States |
| D018352 |
| Coronavirus Infections |
| D003333 | Coronaviridae Infections |
| D030341 | Nidovirales Infections |
| D012327 | RNA Virus Infections |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |