Aplicación de la ecografía pulmonar en atención primaria en pacientes COVID-19

  1. Fernández Rodríguez, Vicente 1
  2. Caeiro Castelao, Jesús Manuel 2
  3. Veras Castro, Ramón 3
  4. López Segade, Paula 1
  5. Anllo López, Carla 3
  6. Bravo Bueno, Begoña 2
  7. Pérez Coello, Lucía 3
  8. Fernández Fernández, Bárbara 1
  9. Pallas Rodríguez, Macarena 2
  1. 1 Centro de Saúde Os Rosales, A Coruña
  2. 2 Centro de Saúde Elviña-Mesoiro, A Coruña
  3. 3 Centro de Saúde San Xosé, A Coruña
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Journal:
Cadernos de atención primaria

ISSN: 1134-3583

Year of publication: 2023

Volume: 29

Issue: 1

Pages: 106-118

Type: Article

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More publications in: Cadernos de atención primaria

Abstract

Objective: Estimate the proportion of COVID-19 cases with lung lesions detected by lung ultrasound in the community setting, as well as their association with clinical variables and vulnerability factors. Design: Cross-sectional observational. Location: Primary Care. Method/measurements: Lung ultrasound (12 sectors) was performed on 216 patients from 3 basic health areas, selected consecutively from patients diagnosed with COVID-19. We consider pathological with grade 1 if it presents alteration of the pleural line and >3 B lines, grade 2 with multiple B lines, confluents or microconsolidations and grade 3 with major consolidations. The lung ultrasonographic score is the sum of the regional scores. Clinical variables, vulnerability factors and their relationship with radiographic results and hospital admission are measured. Results: The proportion of cases with pathological ultrasound is 31.5% (95% CI 25.35-38.13) in the first ultrasound, 35.6% (95% CI 29.27-42.43) in the first and successive. There are more pathological ultrasounds in the 3rd wave, progressively reducing their number and severity. The median number of days for the first examination is 4 (IQR 2-7). 95% of cases with pathological ultrasound had pathological radiography. 9.3% were admitted (95% CI 5.75-13.94), presenting a higher and more severe ultrasonographic score. The pulmonary ultrasonographic score is associated with dyspnea, respiratory rate and reduced oxygen saturation. Conclusions: Lung ultrasound is a differential instrument in the diagnosis and detection of complications in COVID-19 patients in primary care.

Data source: Dialnet