Lung ultrasound is associated with distinct clinical phenotypes in COVID-19 ARDS: A retrospective observational study
ARDS is a heterogeneous syndrome with distinct clinical phenotypes. Here we investigate whether the presence or absence of large pulmonary ultrasonographic consolidations can categorize COVID-19 ARDS patients requiring mechanical ventilation into distinct clinical phenotypes. This is a retrospective...
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| creator | Dayan, Roy Rafael Blau, Maayan Taylor, Jonathan Hasidim, Ariel Galante, Ori Almog, Yaniv Gat, Tomer Shavialiova, Darya Miller, Jacob David Khazanov, Georgi Abu Ghalion, Fahmi Sagy, Iftach Ben Shitrit, Itamar Fuchs, Lior |
| description | ARDS is a heterogeneous syndrome with distinct clinical phenotypes. Here we investigate whether the presence or absence of large pulmonary ultrasonographic consolidations can categorize COVID-19 ARDS patients requiring mechanical ventilation into distinct clinical phenotypes.
This is a retrospective study performed in a tertiary-level intensive care unit in Israel between April and September 2020. Data collected included lung ultrasound (LUS) findings, respiratory parameters, and treatment interventions. The primary outcome was a composite of three ARDS interventions: prone positioning, high PEEP, or a high dose of inhaled nitric oxide.
A total of 128 LUS scans were conducted among 23 patients. The mean age was 65 and about two-thirds were males. 81 scans identified large consolidation and were classified as "C-type", and 47 scans showed multiple B-lines with no or small consolidation and were classified as "B-type". The presence of a "C-type" study had 2.5 times increased chance of receiving the composite primary outcome of advanced ARDS interventions despite similar SOFA scores, Pao2/FiO2 ratio, and markers of disease severity (OR = 2.49, %95CI 1.40-4.44).
The presence of a "C-type" profile with LUS consolidation potentially represents a distinct COVID-19 ARDS subphenotype that is more likely to require aggressive ARDS interventions. Further studies are required to validate this phenotype in a larger cohort and determine causality, diagnostic, and treatment responses. |
| doi_str_mv | 10.1371/journal.pone.0304508 |
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This is a retrospective study performed in a tertiary-level intensive care unit in Israel between April and September 2020. Data collected included lung ultrasound (LUS) findings, respiratory parameters, and treatment interventions. The primary outcome was a composite of three ARDS interventions: prone positioning, high PEEP, or a high dose of inhaled nitric oxide.
A total of 128 LUS scans were conducted among 23 patients. The mean age was 65 and about two-thirds were males. 81 scans identified large consolidation and were classified as "C-type", and 47 scans showed multiple B-lines with no or small consolidation and were classified as "B-type". The presence of a "C-type" study had 2.5 times increased chance of receiving the composite primary outcome of advanced ARDS interventions despite similar SOFA scores, Pao2/FiO2 ratio, and markers of disease severity (OR = 2.49, %95CI 1.40-4.44).
The presence of a "C-type" profile with LUS consolidation potentially represents a distinct COVID-19 ARDS subphenotype that is more likely to require aggressive ARDS interventions. Further studies are required to validate this phenotype in a larger cohort and determine causality, diagnostic, and treatment responses.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0304508</identifier><identifier>PMID: 38829891</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Aged ; Biology and Life Sciences ; Consolidation ; Coronaviruses ; COVID-19 ; COVID-19 - diagnostic imaging ; Female ; Health services ; Humans ; Intensive Care Units ; Lung - diagnostic imaging ; Lungs ; Male ; Mechanical ventilation ; Medicine and Health Sciences ; Middle Aged ; Mortality ; Nitric oxide ; Observational studies ; Patients ; Phenotype ; Phenotypes ; Physical Sciences ; Point of care testing ; Research and Analysis Methods ; Respiration, Artificial ; Respiratory Distress Syndrome - diagnostic imaging ; Retrospective Studies ; SARS-CoV-2 ; Ultrasonography - methods ; Ultrasound ; Ventilation</subject><ispartof>PloS one, 2024-06, Vol.19 (6), p.e0304508</ispartof><rights>Copyright: © 2024 Dayan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>COPYRIGHT 2024 Public Library of Science</rights><rights>2024 Dayan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2024 Dayan et al 2024 Dayan et al</rights><rights>2024 Dayan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><orcidid>0000-0003-1785-0952 ; 0000-0001-8987-3673</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11146726/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11146726/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,23866,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38829891$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dayan, Roy Rafael</creatorcontrib><creatorcontrib>Blau, Maayan</creatorcontrib><creatorcontrib>Taylor, Jonathan</creatorcontrib><creatorcontrib>Hasidim, Ariel</creatorcontrib><creatorcontrib>Galante, Ori</creatorcontrib><creatorcontrib>Almog, Yaniv</creatorcontrib><creatorcontrib>Gat, Tomer</creatorcontrib><creatorcontrib>Shavialiova, Darya</creatorcontrib><creatorcontrib>Miller, Jacob David</creatorcontrib><creatorcontrib>Khazanov, Georgi</creatorcontrib><creatorcontrib>Abu Ghalion, Fahmi</creatorcontrib><creatorcontrib>Sagy, Iftach</creatorcontrib><creatorcontrib>Ben Shitrit, Itamar</creatorcontrib><creatorcontrib>Fuchs, Lior</creatorcontrib><title>Lung ultrasound is associated with distinct clinical phenotypes in COVID-19 ARDS: A retrospective observational study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>ARDS is a heterogeneous syndrome with distinct clinical phenotypes. Here we investigate whether the presence or absence of large pulmonary ultrasonographic consolidations can categorize COVID-19 ARDS patients requiring mechanical ventilation into distinct clinical phenotypes.
This is a retrospective study performed in a tertiary-level intensive care unit in Israel between April and September 2020. Data collected included lung ultrasound (LUS) findings, respiratory parameters, and treatment interventions. The primary outcome was a composite of three ARDS interventions: prone positioning, high PEEP, or a high dose of inhaled nitric oxide.
A total of 128 LUS scans were conducted among 23 patients. The mean age was 65 and about two-thirds were males. 81 scans identified large consolidation and were classified as "C-type", and 47 scans showed multiple B-lines with no or small consolidation and were classified as "B-type". The presence of a "C-type" study had 2.5 times increased chance of receiving the composite primary outcome of advanced ARDS interventions despite similar SOFA scores, Pao2/FiO2 ratio, and markers of disease severity (OR = 2.49, %95CI 1.40-4.44).
The presence of a "C-type" profile with LUS consolidation potentially represents a distinct COVID-19 ARDS subphenotype that is more likely to require aggressive ARDS interventions. Further studies are required to validate this phenotype in a larger cohort and determine causality, diagnostic, and treatment responses.</description><subject>Aged</subject><subject>Biology and Life Sciences</subject><subject>Consolidation</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>COVID-19 - diagnostic imaging</subject><subject>Female</subject><subject>Health services</subject><subject>Humans</subject><subject>Intensive Care Units</subject><subject>Lung - diagnostic imaging</subject><subject>Lungs</subject><subject>Male</subject><subject>Mechanical ventilation</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Nitric oxide</subject><subject>Observational studies</subject><subject>Patients</subject><subject>Phenotype</subject><subject>Phenotypes</subject><subject>Physical Sciences</subject><subject>Point of care testing</subject><subject>Research and Analysis Methods</subject><subject>Respiration, Artificial</subject><subject>Respiratory Distress Syndrome - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dayan, Roy Rafael</au><au>Blau, Maayan</au><au>Taylor, Jonathan</au><au>Hasidim, Ariel</au><au>Galante, Ori</au><au>Almog, Yaniv</au><au>Gat, Tomer</au><au>Shavialiova, Darya</au><au>Miller, Jacob David</au><au>Khazanov, Georgi</au><au>Abu Ghalion, Fahmi</au><au>Sagy, Iftach</au><au>Ben Shitrit, Itamar</au><au>Fuchs, Lior</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Lung ultrasound is associated with distinct clinical phenotypes in COVID-19 ARDS: A retrospective observational study</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2024-06-03</date><risdate>2024</risdate><volume>19</volume><issue>6</issue><spage>e0304508</spage><pages>e0304508-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>ARDS is a heterogeneous syndrome with distinct clinical phenotypes. Here we investigate whether the presence or absence of large pulmonary ultrasonographic consolidations can categorize COVID-19 ARDS patients requiring mechanical ventilation into distinct clinical phenotypes.
This is a retrospective study performed in a tertiary-level intensive care unit in Israel between April and September 2020. Data collected included lung ultrasound (LUS) findings, respiratory parameters, and treatment interventions. The primary outcome was a composite of three ARDS interventions: prone positioning, high PEEP, or a high dose of inhaled nitric oxide.
A total of 128 LUS scans were conducted among 23 patients. The mean age was 65 and about two-thirds were males. 81 scans identified large consolidation and were classified as "C-type", and 47 scans showed multiple B-lines with no or small consolidation and were classified as "B-type". The presence of a "C-type" study had 2.5 times increased chance of receiving the composite primary outcome of advanced ARDS interventions despite similar SOFA scores, Pao2/FiO2 ratio, and markers of disease severity (OR = 2.49, %95CI 1.40-4.44).
The presence of a "C-type" profile with LUS consolidation potentially represents a distinct COVID-19 ARDS subphenotype that is more likely to require aggressive ARDS interventions. Further studies are required to validate this phenotype in a larger cohort and determine causality, diagnostic, and treatment responses.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>38829891</pmid><doi>10.1371/journal.pone.0304508</doi><tpages>e0304508</tpages><orcidid>https://orcid.org/0000-0003-1785-0952</orcidid><orcidid>https://orcid.org/0000-0001-8987-3673</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | PloS one, 2024-06, Vol.19 (6), p.e0304508 |
| issn | 1932-6203 1932-6203 |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Aged Biology and Life Sciences Consolidation Coronaviruses COVID-19 COVID-19 - diagnostic imaging Female Health services Humans Intensive Care Units Lung - diagnostic imaging Lungs Male Mechanical ventilation Medicine and Health Sciences Middle Aged Mortality Nitric oxide Observational studies Patients Phenotype Phenotypes Physical Sciences Point of care testing Research and Analysis Methods Respiration, Artificial Respiratory Distress Syndrome - diagnostic imaging Retrospective Studies SARS-CoV-2 Ultrasonography - methods Ultrasound Ventilation |
| title | Lung ultrasound is associated with distinct clinical phenotypes in COVID-19 ARDS: A retrospective observational study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-20T20%3A40%3A07IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Lung%20ultrasound%20is%20associated%20with%20distinct%20clinical%20phenotypes%20in%20COVID-19%20ARDS:%20A%20retrospective%20observational%20study&rft.jtitle=PloS%20one&rft.au=Dayan,%20Roy%20Rafael&rft.date=2024-06-03&rft.volume=19&rft.issue=6&rft.spage=e0304508&rft.pages=e0304508-&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0304508&rft_dat=%3Cgale_plos_%3EA796141767%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=3069269581&rft_id=info:pmid/38829891&rft_galeid=A796141767&rft_doaj_id=oai_doaj_org_article_55f63780faf5467fbbc0c6ef6b364040&rfr_iscdi=true |