COVUS: An Algorithm to Maximize the Use of Point-of-care Ultrasound in the Emergency Management of COVID-19

Coneybeare, Di; Das, Devjani; Lema, Penelope; Chang, Bernard; Ng, Lorraine

Background Patients with COVID-19 present with diagnostic challenges as it can cause varied end-organ failures that mimic respiratory distress of pulmonary origin. Early identification of concurrent complications can significantly alter patient management and course. Point-of-care ultrasound (POCUS) can be particularly useful in helping to differentiate concomitant complications with COVID-19. While lung POCUS findings related to COVID-19 have been published, little guidance exists on how ultrasound can be incorporated into a more comprehensive evaluation of patients under investigation (PUI) for COVID-19. Objectives We devised a pathway called COVUS that incorporates POCUS into the initial evaluation of PUIs for COVID-19 to guide diagnosis and management. Discussion The pathway was derived based on review of literature, consensus from the ultrasound faculty, as well as feedback from the entire faculty group at one academic institution with high volumes of COVID-19 patients. The scanning protocol utilizes a cardiac first, rather than lung first, approach to identify potential concomitant organ failure that may immediately alter management. Conclusions COVUS aims to maximize identification of the most immediately life-threatening complications while minimizing time at bedside and provider risk of exposure to COVID-19.