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New Score to Diagnose Covid 19 Infection Using Lung Ultrasound
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  • Mohammad El Tahlawi,
  • hisham samir,
  • Mohammad Walaa,
  • Panagiota Manthou,
  • Diego Arazia-Garaygordobil,
  • Mohammad Elshabrawy,
  • Mohamed Elkholy,
  • Waleed Mansour
Mohammad El Tahlawi
Zagazig University Faculty of Human Medicine
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hisham samir
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Mohammad Walaa
Zagazig University Faculty of Human Medicine
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Panagiota Manthou
National and Kapodistrian University of Athens
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Diego Arazia-Garaygordobil
Instituto Nacional de Cardiologia Ignacio Chavez
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Mohammad Elshabrawy
Zagazig University Faculty of Human Medicine
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Mohamed Elkholy
Zagazig University Faculty of Agriculture
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Waleed Mansour
Zagazig University Faculty of Human Medicine
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Abstract

Background: PCR used for SARS‐CoV‐2 diagnosis is variable and unstable. Lung ultrasound has good safety and accuracy in pneumonia. We aim to evaluate the ability of bedside lung ultrasound in suspecting the diagnosis and/or predicting the prognosis of Covid 19 infection. Patients & Methods: We recruited any case with pulmonary symptoms necessitating admission in intermediate care and/or ICU during the period between 27th March and 11th April 2020 in 3 international centres. Patients were stratified according to Covid 19 PCR results. All patients underwent chest X ray, CT, lung ultrasound, echocardiography and laboratory analysis. Results: Eighty-two cases were recruited. Fifty cases (61%) were negative for SARS‐CoV‐2 while 32 cases (39%) were positive. Sixty-four cases (78%) were recovered while 18 cases (22%) died. Covid 19 patients had more A profile and more abnormal A lines than non-Covid 19 group (p<0.001). Smoking, congestion in X ray, A profile and abnormal A lines in lung ULS are independent predictors for Covid 19 infection. A scoring system for prediction of Covid 19 using clinical and radiological data was calculated with a sensitivity of 93.8% and a specificity of 58%. Mortality in Covid 19 patients is significantly correlated with age, duration of fever, presence of cardiac disease, B profile and abnormal A lines by lung ULS. However, it is negatively correlated with initial O2 saturation and EF by echocardiography Conclusion: Lung ULS could predict SARS‐CoV‐2 infection among patients with pulmonary symptoms necessitating admission. Lung ULS can also predict the outcome of Covid 19 infected patients.