Abstract
Sommario. La malattia da SARS-CoV-2 ha richiesto ai medici curanti uno sforzo notevole nell’adattare il proprio metodo di lavoro. In breve tempo abbiamo dovuto conoscere la malattia e attuare una strategia per la presa in carico dei pazienti. Lo scopo è quello di riuscire a fornire nella Praxis una consulenza sicura (senza contaminazioni dei pazienti), con diagnosi precoce e follow-up riproducibile. L’ecografia polmonare è risultata essere una metodica sicura e affidabile per la diagnosi di questa malattia durante la pandemia. In questo articolo viene descritta l’esperienza conseguita su 116 pazienti nel periodo compreso tra febbraio 2020 a marzo 2021.
Abstract. SARS-CoV-2 disease has required significant efforts from treating physicians to adapt their working methods. In a short time, we had to get to know the disease and implement a strategy for patient care. The goal is to provide safe consultation in the office (without contaminating patients), providing an early diagnosis and reproducible follow-up. Lung ultrasound proved to be a safe and reliable method for diagnosing this disease during the pandemic. This article describes the experience gained by treating 116 patients between February 2020 and March 2021.
Zusammenfassung. Die SARS-CoV-2-Erkrankung hat von den behandelnden Ärztinnen und Ärzten erhebliche Anstrengungen bei der Anpassung ihrer Arbeitsmethoden erfordert. In kurzer Zeit musste die Krankheit kennengelernt und eine Strategie für die Patientenversorgung umgesetzt werden. Ziel ist es, eine sichere Beratung in der Hausarztpraxis (ohne Kontamination der Patientinnen und Patienten) mit frühzeitiger Diagnose und reproduzierbarer Nachsorge durchführen zu können. Der Lungenultraschall erwies sich als sichere und zuverlässige Methode zur Diagnose von SARS-CoV-2 während der Pandemie. Dieser Artikel beschreibt die Erfahrungen, die bei 116 Patientinnen und Patienten im Zeitraum von Februar 2020 bis März 2021 gemacht wurden.
Bibliografia
International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med. 2012;38(4):577–591.
,Lung ultrasound for critically ill patients. Am J Respir Crit Care Med. 2019;199(6):701–714.
.Chest CT for typical 2019-nCoV pneumonia: Relationship to negative RT-PCR testing. Radiology. 2020:200343. DOI: 10.1148/radiol.2020200343.
,Sensitivity of chest CT for COVID-19: Comparison to RT-PCR. Radiology. 2020 Feb 19:200432. DOI: 10.1148/radiol.2020200432.
,Patients with RT-PCR confirmed COVID-19 and normal chest CT. Radiology. 2020 Mar 6:200702. DOI: 10.1148/radiol.2020200702.
.Prognostic value of leukocytosis and lymphopenia for coronavirus disease severity. Emerg Infect Dis. 2020. https://doi.org/10.3201/eid2608.201160.
.Can Lung US help critical care clinicians in the early diagnosis of novel coronavirus pneumonia? Radiology. 2020 Mar 13:200847. DOI: 10.1148/radiol.2020200847.
,Is there a role for lung ultrasound during the COVID-19 pandemic? J Ultrasound Med. 2020;39(7): 1459–1462.
,Proposal for international standardization of the use of lung ultrasound for COVID-19 patients; a simple, quantitative, reproducible method. J Ultrasound Med. 2020. https://doi: 10.1002/jum.15285.
,Corticosteroid therapy in critically ill patients with COVID-19: a multicenter, retrospective study. Critical Care. 2020; Volume 24, Article No 698.
,Pros and cons of corticosteroid therapy for COVID-19 patients. Respir Physiol Neurobiol. 2020; 280: 103492. https://doi:10.1016/j.resp.2020.103492.
,Low-cost dexamethasone reduces death by up to one third in hospitalised patients with severe respiratory complications of COVID-19. University of Oxford, 2020. https://www.recoverytrial.net/files/recovery_dexametha sone_statement_160620_v2 final.pdf. last access: 07.04.2021.
.COVID-19 outbreak: less stethoscope, more ultrasound. Lancet Respir Med. 2020; pii: S2213–S2600(20)30120-X. DOI: 10.1016/S2213-2600(20)301 20-X.
.