目的:一些研究报告血栓栓塞事件在重症COVID-19病例中很常见。我们试图调查住院COVID-19患者的肺部超声(LUS)发现与静脉血栓栓塞事件(VTE)发展之间的关系。
方法:这项前瞻性多中心研究共纳入了COVID-19病房的203名成年人(平均年龄68.6岁,56.7%男性)。所有患者均接受8区LUS检查,所有超声图像均采用离线盲法分析。调查了几个LUS发现(B线总数,B线得分,和LUS分数)。
结果:从入院到LUS检查的中位时间为4天(IQR:2,8)。B线的中位数为12(IQR:8,18),和44(21.7%)的B线评分为阳性。住院期间,17例患者发生了VTE(4例深静脉血栓形成,15肺栓塞),12个在LUS之前,5个在LUS之前。在完全调整的多变量Cox模型中(不包括在LUS之前有VTE的参与者),所有LUS参数均与VTE显着相关(B线总数:HR=1.14,95%CI(1.03,1.26)每增加1个B线),阳性B线评分:HR=9.79,95%CI(1.87,51.35),和LUS评分:HR=1.51,95%CI(1.10,2.07),每增加1个点)。在敏感性分析中,B线评分和LUS评分仍与VTE显着相关。
结论:在住院的COVID-19患者中,病理LUS表现很常见,以及B线的总数,B线得分,LUS评分均与VTE相关。这些结果表明,LUS检查可能有助于COVID-19的风险分层和临床管理。这些发现应该被认为是假设的产生。
结果:
■NCT04377035。
OBJECTIVE: 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.
CONCLUSIONS: 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.
RESULTS: UNASSIGNED: NCT04377035.