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

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DOI

  • Kristoffer Grundtvig Skaarup, Københavns Universitet
  • ,
  • Mats Christian Højbjerg Lassen, Københavns Universitet
  • ,
  • Caroline Espersen, Københavns Universitet
  • ,
  • Jannie Nørgaard Lind, Københavns Universitet
  • ,
  • Niklas Dyrby Johansen, Københavns Universitet
  • ,
  • Morten Sengeløv, Københavns Universitet
  • ,
  • Alia Saed Alhakak, Københavns Universitet
  • ,
  • Anne Bjerg Nielsen, Cardiovascular Non-Invasive Imaging Research Laboratory, Københavns Universitet
  • ,
  • Kirstine Ravnkilde, Københavns Universitet
  • ,
  • Raphael Hauser, Københavns Universitet
  • ,
  • Liv Borum Schöps, Københavns Universitet
  • ,
  • Eva Holt, Københavns Universitet
  • ,
  • Henning Bundgaard, Københavns Universitet
  • ,
  • Christian Hassager, Københavns Universitet
  • ,
  • Reza Jabbari, Københavns Universitet
  • ,
  • Jørn Carlsen, Københavns Universitet
  • ,
  • Ole Kirk, Københavns Universitet
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  • Uffe Bodtger, Syddansk Universitet
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  • Matias Greve Lindholm, Sjællands Universitetshospital
  • ,
  • Lothar Wiese, Sjællands Universitetshospital
  • ,
  • Ole Peter Kristiansen, Københavns Universitet
  • ,
  • Emil Schwarz Walsted, Københavns Universitet
  • ,
  • Olav Wendelboe Nielsen, Københavns Universitet
  • ,
  • Birgitte Lindegaard, Københavns Universitet
  • ,
  • Niels Tønder, Københavns Universitet
  • ,
  • Klaus Nielsen Jeschke, Københavns Universitet
  • ,
  • Charlotte Suppli Ulrik, Københavns Universitet
  • ,
  • Morten Lamberts, Københavns Universitet
  • ,
  • Pradeesh Sivapalan, Københavns Universitet
  • ,
  • Jannik Pallisgaard, Københavns Universitet
  • ,
  • Gunnar Gislason, Københavns Universitet
  • ,
  • Kasper Iversen, Cardiovascular Non-Invasive Imaging Research Laboratory, Københavns Universitet
  • ,
  • Jens Ulrik Stæhr Jensen, Københavns Universitet
  • ,
  • Morten Schou, Cardiovascular Non-Invasive Imaging Research Laboratory, Københavns Universitet
  • ,
  • Søren Helbo Skaarup
  • Elke Platz, Harvard University
  • ,
  • Tor Biering-Sørensen, Københavns Universitet

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

Bibliografisk note

Funding Information:
TBS reports receiving research grants from Sanofi Pasteur and GE Healthcare, is a Steering Committee member of the Amgen financed GALACTIC-HF trial, on advisory boards for Sanofi Pasteur and Amgen, and speaker honorariums from Novartis and Sanofi Pasteur. EP has received research support from the NIH outside the submitted work, and consulting fees from scPharmaceuticals outside the submitted work. Her employer has received support from Novartis for consulting work outside the submitted work. The remaining authors have nothing to disclose in relation to the present project.

Funding Information:
TBS, together with KGS and MHL, received a research grant from the Novo Nordisk Foundation to conduct the study. Europcar Denmark provided cars for KGS and MHL to transport the equipment from hospital to hospital. TBS received funds from Herlev and Gentofte Hospital and the Lundbeck foundation while conducting this study. The sponsors had no role in the design and interpretation of the data.

Publisher Copyright:
© 2021, Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB).

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