Current best evidence for clinical care (more info)
COVID-19 has caused great devastation in the past year. Multi-organ point-of-care ultrasound (PoCUS) including lung ultrasound (LUS) and focused cardiac ultrasound (FoCUS) as a clinical adjunct has played a significant role in triaging, diagnosis and medical management of COVID-19 patients. The expert panel from 27 countries and 6 continents with considerable experience of direct application of PoCUS on COVID-19 patients presents evidence-based consensus using GRADE methodology for the quality of evidence and an expedited, modified-Delphi process for the strength of expert consensus. The use of ultrasound is suggested in many clinical situations related to respiratory, cardiovascular and thromboembolic aspects of COVID-19, comparing well with other imaging modalities. The limitations due to insufficient data are highlighted as opportunities for future research.
| Discipline / Specialty Area | Score |
|---|---|
| Emergency Medicine | |
| Intensivist/Critical Care | |
| Respirology/Pulmonology | |
| Hospital Doctor/Hospitalists | |
| Internal Medicine | |
| Cardiology | |
Instructive scoping review and consensus panel on multi-purpose applications of point-of-care ultrasound in the evaluation and management of COVID-19 patients. The methods by which authors "GRADEd" the evidence (who performed assessments using what structure/criteria) is unclear as are the specific sub-types of diagnostic bias (incorporation, differential verification, imperfect criterion standard, etc - see https://onlinelibrary.wiley.com/doi/full/10.1111/acem.14048). Nonetheless. This is an instructive document on which to build local POCUS protocols.
This is a consensus document on POCUS for the diagnosis of COVID-19 and for ongoing management in critical COVID-19 patients. Although this review has a nice summary of recommendations, it`s important to note the following: 1) the studies cited for evidence directly related to COVID-19 are mainly observational; 2) the recommendations are built on a modified Delphi technique from an expert panel in ultrasound. The latter may create an intellectual bias on their recommendations. This may be appropriate for those proficient in ultrasound, but the recommendations may not be applicable for everyone, especially those who are not proficient.
Very broad in scope and is more of a cataloging of all possible uses of ultrasound in COVID patients. Many recommendations are general or intuitive; some are useful, many less so.
POCUS is becoming an increasingly popular diagnostic tool and soon will become a must-have tool for clinicians. During the COVID pandemic, sharing a US machine poses an infection transmission risk unless it is thoroughly decontaminated or designed only for the COVID unit.
A useful summary of POCUS in COVID with guidance / recommendations. Most of the data are not new and come from non-COVID studies and patients, but still helpful.
Very interesting study. May be more widely applicable beyond just the COVID issues discussed.
This is a very nice consensus document on the potential use of ultrasound in COVID-19. Although not a formal guideline per se, this provides helpful guidance for users of POCUS, particularly with the increasing availability of small portable ultrasound machines.
This is a concise but meaty review of the literature on the use of lung, cardiac, and other ultrasonic procedures in the diagnosis and management of organ involvement and function in COVID-19 infection. The potential applications are discussed and preliminary recommendations of ultrasound use in COVID-19 infections are made.