Predicting Outcomes for Covid-19 Using Sonography

Study Overview
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Brief Summary
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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.

Detailed Description
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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.

Official Title
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Predicting Outcomes for Covid-19 Using Sonography

Conditions
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COVID-19, Pneumonia, Viral

Intervention / Treatment
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* Diagnostic Test: Lung Ultrasound


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Any adult (18 or more years of age) presenting to the emergency department with symptoms suspicious for Covid-19 This individual underwent evaluation for Covid-19 via a nasopharyngeal RT-PCR This individual received a lung ultrasound by the study authors within 28 days from initial evaluation Exclusion Criteria: Any individual who did not receive a lung ultrasound within 28 days from initial evaluation for covid-19 related illness

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Covid-19 Positive Patients<br>This group includes individuals who were diagnosed with Covid-19 based on reverse transcriptase polymerase chain reaction (RT-PCR) of the nasopharynx | Diagnostic Test: Lung Ultrasound<br>* Lung ultrasound will be performed on patients undergoing investigation for covid-19 based on a nasopharyngeal PCR.<br>|
| Covid-19 Negative Patients<br>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. | Diagnostic Test: Lung Ultrasound<br>* Lung ultrasound will be performed on patients undergoing investigation for covid-19 based on a nasopharyngeal PCR.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | 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 | 

Secondary Outcome Measures

| Outcome Measure | 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 | 
| 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 |