Bedside chest ultrasound to distinguish heart failure from pneumonia‐related dyspnoea in older COVID‐19 patients

Abstract Aims In the older population, acute heart failure is a frequent, life‐threatening complication of COVID‐19 that requires urgent specific care. We aimed to explore the impact of point‐of‐care chest ultrasound (CUS) use in older bedridden inpatients during the COVID‐19 pandemic as a tool to d...

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Main Authors: Arthur Hacquin, Sophie Putot, Jérémy Barben, Frédéric Chagué, Marianne Zeller, Yves Cottin, Patrick Manckoundia, Alain Putot
Format: Article
Language:English
Published: Wiley 2020-12-01
Series:ESC Heart Failure
Subjects:
Online Access:https://doi.org/10.1002/ehf2.13017
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author Arthur Hacquin
Sophie Putot
Jérémy Barben
Frédéric Chagué
Marianne Zeller
Yves Cottin
Patrick Manckoundia
Alain Putot
author_facet Arthur Hacquin
Sophie Putot
Jérémy Barben
Frédéric Chagué
Marianne Zeller
Yves Cottin
Patrick Manckoundia
Alain Putot
author_sort Arthur Hacquin
collection DOAJ
description Abstract Aims In the older population, acute heart failure is a frequent, life‐threatening complication of COVID‐19 that requires urgent specific care. We aimed to explore the impact of point‐of‐care chest ultrasound (CUS) use in older bedridden inpatients during the COVID‐19 pandemic as a tool to distinguish between cardiogenic pulmonary oedema and isolated viral pneumonia‐related dyspnoea. Methods and results This prospective series included 16 patients aged 75 or older, hospitalized for acute dyspnoea in an acute geriatric unit of a university hospital and testing positive for a SARS‐Cov2 infection. We collected demographic characteristics, medical history, biological screening, clinical symptoms, CUS findings (n = 16) and chest CT‐scan conclusions (n = 14). Mean age was 89 years (77–97). All patients presented asthenia and dyspnoea, 56% complained of coughing and diarrhoea, and 50% had fever. Acute heart failure was clinically suspected in seven patients. At CUS, evidence of heart failure was confirmed in three patients (including one without clinical suspicion); interstitial syndrome was confirmed in 12 patients on CUS vs. 9 patients with CT. Conclusions In older patients with COVID‐19 and acute dyspnoea, the use of point‐of‐care CUS allowed the clinician to quickly rule out heart failure in nearly half of suspected cases while easily identifying virus‐related interstitial syndrome. The use of CUS appears to be suitable for the rapid bedside investigation of dyspnoea in older patients, particularly in the context of the COVID‐19 pandemic.
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spelling doaj.art-2438e0de1f644574a0c3c50db7f8c2ab2022-12-21T17:26:48ZengWileyESC Heart Failure2055-58222020-12-01764424442810.1002/ehf2.13017Bedside chest ultrasound to distinguish heart failure from pneumonia‐related dyspnoea in older COVID‐19 patientsArthur Hacquin0Sophie Putot1Jérémy Barben2Frédéric Chagué3Marianne Zeller4Yves Cottin5Patrick Manckoundia6Alain Putot7Department of Geriatrics and Internal Medicine, Hospital of Champmaillot Dijon University Hospital Dijon FranceDepartment of Geriatrics and Internal Medicine, Hospital of Champmaillot Dijon University Hospital Dijon FranceDepartment of Geriatrics and Internal Medicine, Hospital of Champmaillot Dijon University Hospital Dijon FranceDepartment of Cardiology Dijon University Hospital Dijon FranceEA7460, Physiopathologie et Epidémiologie Cérébrovasculaires University of Burgundy Franche‐Comté Dijon FranceDepartment of Cardiology Dijon University Hospital Dijon FranceDepartment of Geriatrics and Internal Medicine, Hospital of Champmaillot Dijon University Hospital Dijon FranceDepartment of Geriatrics and Internal Medicine, Hospital of Champmaillot Dijon University Hospital Dijon FranceAbstract Aims In the older population, acute heart failure is a frequent, life‐threatening complication of COVID‐19 that requires urgent specific care. We aimed to explore the impact of point‐of‐care chest ultrasound (CUS) use in older bedridden inpatients during the COVID‐19 pandemic as a tool to distinguish between cardiogenic pulmonary oedema and isolated viral pneumonia‐related dyspnoea. Methods and results This prospective series included 16 patients aged 75 or older, hospitalized for acute dyspnoea in an acute geriatric unit of a university hospital and testing positive for a SARS‐Cov2 infection. We collected demographic characteristics, medical history, biological screening, clinical symptoms, CUS findings (n = 16) and chest CT‐scan conclusions (n = 14). Mean age was 89 years (77–97). All patients presented asthenia and dyspnoea, 56% complained of coughing and diarrhoea, and 50% had fever. Acute heart failure was clinically suspected in seven patients. At CUS, evidence of heart failure was confirmed in three patients (including one without clinical suspicion); interstitial syndrome was confirmed in 12 patients on CUS vs. 9 patients with CT. Conclusions In older patients with COVID‐19 and acute dyspnoea, the use of point‐of‐care CUS allowed the clinician to quickly rule out heart failure in nearly half of suspected cases while easily identifying virus‐related interstitial syndrome. The use of CUS appears to be suitable for the rapid bedside investigation of dyspnoea in older patients, particularly in the context of the COVID‐19 pandemic.https://doi.org/10.1002/ehf2.13017COVID‐19DyspnoeaHeart failureAgedPneumoniaPoint‐of‐care ultrasound
spellingShingle Arthur Hacquin
Sophie Putot
Jérémy Barben
Frédéric Chagué
Marianne Zeller
Yves Cottin
Patrick Manckoundia
Alain Putot
Bedside chest ultrasound to distinguish heart failure from pneumonia‐related dyspnoea in older COVID‐19 patients
ESC Heart Failure
COVID‐19
Dyspnoea
Heart failure
Aged
Pneumonia
Point‐of‐care ultrasound
title Bedside chest ultrasound to distinguish heart failure from pneumonia‐related dyspnoea in older COVID‐19 patients
title_full Bedside chest ultrasound to distinguish heart failure from pneumonia‐related dyspnoea in older COVID‐19 patients
title_fullStr Bedside chest ultrasound to distinguish heart failure from pneumonia‐related dyspnoea in older COVID‐19 patients
title_full_unstemmed Bedside chest ultrasound to distinguish heart failure from pneumonia‐related dyspnoea in older COVID‐19 patients
title_short Bedside chest ultrasound to distinguish heart failure from pneumonia‐related dyspnoea in older COVID‐19 patients
title_sort bedside chest ultrasound to distinguish heart failure from pneumonia related dyspnoea in older covid 19 patients
topic COVID‐19
Dyspnoea
Heart failure
Aged
Pneumonia
Point‐of‐care ultrasound
url https://doi.org/10.1002/ehf2.13017
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