Specific Aims: 1. The investigators will prospectively evaluate and analyze changes in the appearance of the lungs and heart through serial acquisition of focused point-of-care ultrasound images in a cohort of patients with or under investigation for COVID-19. 2. The investigators will correlate changes noted in ultrasound with clinical course and diagnostic evaluation to ascertain whether changes on ultrasound could improve care through earlier diagnosis or identification of patients at high risk of disease progression.
The investigators will perform a descriptive study aimed at identifying the cardiopulmonary
ultrasound features in patients with or under investigation for COVID-19.
The study will take place at two sites: University of Minnesota Medical Center (UMMC) and
Bethesda Hospital. At UMMC, a tertiary care center, clinicians will recruit and evaluate
patients with or under investigation for COVID-19. At Bethesda clinicians will recruit and
evaluate patients with a confirmed diagnosis of COVID-19 as demonstrated by a positive
PT-PCR.
POCUS exams will be performed in a cohort of 200-500 patients with or under investigation for
COVID-19. Serial ultrasound examinations will be performed every 48-72 hours until discharge,
death, or study completion. Participants will undergo POCUS at enrollment by their treating
physicians. Inquiry into study enrollment will be performed over the phone rather than in
person, given the current scarcity of PPE and the added use that would occur with in-person
enrollment.
Diagnostic Test: Point-of-Care Ultrasonography (POCUS)
The POCUS exam of the heart will capture 2 standard views commonly used to assess general cardiac function at the point of care. The details of POCUS views and exam findings of interest are outline below:
Pulmonary POCUS Evaluation:
B lines: absent (< 3 lines), present (> 3 lines), fused
Consolidation: yes or no
a. Bilateral: yes or no
Pleural Effusion: yes or no
Other pleural abnormalities: yes or no Score each finding based on degree of abnormalities and number of sites with abnormalities
Cardiac POCUS Evaluation:
Parasternal long axis
Parasternal short axis
Qualitative LVEF: Normal, hyperdynamic, mild-moderately depressed, severely depressed
EPSS (E-point septal separation): normal (<10 mm), abnormal (>10 mm)
Left ventricular (LV) mass approximation by septal thickness
Left Ventricular Chamber Size by internal diameter at diastole
Inclusion Criteria:
- patients under investigation for COVID-19
- patients that are positive for COVID-19 at UMMC and Bethesda
Exclusion Criteria:
- ultrasound contraindication such as overlying skin wound
University of Minnesota Medical Center (UMMC)
Minneapolis, Minnesota, United States
M Health Fairview Bethesda Hospital
Saint Paul, Minnesota, United States
Matthew Yocum, MD, Principal Investigator
University of Minnesota