Winfocus and
COVID-19
Pandemic

Dr. Arif Hussain

A message from the President

Dear Friends,

As the world faces the formidable challenges of COVID-19 in an unprecedented manner in the recent history, we at WINFOCUS recognize that our organization also has a very definite global role to play.
While we are engaged in caring for the sick patients infected with this strain of Coronavirus in different countries individually we are also sharing our experiences collectively.
Ultrasound, especially at the point of care is proving to be an extremely valuable tool and although the hard data are still lacking, those who are utilizing this modality are already reporting how it could help triage patients in the overburdened healthcare systems, aid in diagnosis and management of critically ill patients.
The training provided by WINFOCUS through courses and workshops using an integrated multi-organ system approach and leading the world in the development and training in lung ultrasound for almost two decades are proving to be most appropriate and fruitful in this hour of global crisis.

WINFOCUS has also been engaged in several telemedicine (teleultrasound) and humanitarian projects in several countries over the years and we hope that those efforts will be useful for the humanity at this time. We intend to remain focused on them and continue to intensify them as our resources permit.
What is unique in dealing with COVID-19 is that we have been sharing an incredible amount of very valuable information in almost real time manner on the internet.
In the coming days and weeks we will also share our experiences and learning resources on our website relevant to the challenges we are facing on a daily basis.
We will also try to provide as much hands-on training at all levels as it is logistically possible and appropriate in the clinical settings, in addition to teaching and maintaining the best infection control practices. We wish you all and your loved ones good health. Your personal safety is extremely important.
Let us stay connected and supportive to each other, that is the hallmark of our organization.

ArifHussain_Sign

Dr. Arif Hussein
WINFOCUS President

COVID-19 Global Cases

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COVID-19 Documentation

View the latest WINFOCUS news, article and guidelines to fight the Covid19 Pandemia.

Covid-19 Infection. Diagnosis, monitoring and prognosis. Is it possible?

Diagnosis, monitoring and prognosis. Is it possible? 

Giovanni Volpicelli, WINFOCUS Board of Directors member opens an ultrasound world in the field of Covid infection.

Giovanni Volpicelli, WINFOCUS Board of Directors member, nos abre un mundo ecográfico en el terreno de la infección por Covid-19. Diagnóstico, monitorización y pronóstico. ¿Es posible?

Thanks to Juanjo Zafra and É.PI.CA. PODCAST for the video-interview. Click here for more videos.

LUNG ULTRASOUND IN COVID 19 PANDEMIC

Elmo Fabiano Monteiro Pereira Jr., Marcos de Carvalho Bethlem, Ana Luisa Silveira Vieira, Marcus Gomes Bastos, José Muniz Pazeli Jr

Until now, we had 3.551 suspected cases of coronavírus related disease SARS-CoV-2 (COVID-19) in Brazil, with 428 confirmed cases and 1.841 cases discarted. 11.278 remain undiagnosed[1].

In the initial phase, the use of the molecular test can have a sensibility of 60 to 70%. CT Scan seems to be the most sensitive tool[2].  The availability of CT scan devices in Brazil is limited[3].

The main finding related to COVID-19 is the presence of peripheral ground glass opacities [4,5].

The peripheral finding in CT scan can be visualized by lung ultrasound, with high concordance[6]

Click on the links below to download the documentation:

Under Pressure, One Italian Doctor Triages by Ultrasound

Liam Davenport. March 24, 2020

Patients have been arriving at the emergency department of the University Hospital San Luigi Gonzaga, in Turin, Italy, one after another after another.

At first, physicians thought advanced age was a good predictor of which cases might go downhill fast. They were wrong. “We intubated a woman who was 38 years old,” says Giovanni Volpicelli, MD. “We see otherwise healthy patients with acute symptoms of pneumonia due to the virus.” And the more patients they see, he says, “the more we see that anyone over 30 is affected.”

Because they couldn’t use age nor underlying condition to predict which patients would develop severe COVID-19-associated pneumonia, they needed a new approach.

That’s what led Volpicelli, a leading expert in treating patients on the coronavirus front lines, to develop a method that can separate out the lethal from the less dangerous cases: triage via ultrasound.

The technique has not yet been peer reviewed, but Volpicelli and his colleagues are now convinced that lung ultrasounds should be done at the bedside for all patients suspected of infection with the novel coronavirus. Even people with mild symptoms, he says, could harbor lung disease that quickly leads to severe pneumonia and respiratory failure.

In his experience, ultrasound assessment effectively separates those who need to be admitted from those who can be sent home to convalesce under quarantine.

Building a Triage Protocol

He and his team have developed a standard approach that starts with a nurse classifying patients based on whether they have fever, cough, or labored breathing — just one of those symptoms is enough to prompt suspicion and the patient is moved into isolation. Then, Volpicelli says, after an examination, “the first thing we do is lung ultrasound.”

That’s because, as the pandemic tore through his city, he began to see that so many patients presented with a negative chest X-ray but a lung ultrasound that was positive for interstitial pneumonia.

Ultrasounds, he discovered, were very useful to both screen for and diagnose someone with the disease. “Only by using a test that can assess the situation of the lung at the beginning of the disease do you become aware that pneumonia can also be present…even in patients with mild or almost no symptoms — just a little bit of fever,” Volpicelli says.

More often than not, an ultrasound is negative and emergency department staff continue their diagnostics. They swab nasal passages for testing with RT-polymerase chain reaction (rRT-PCR), then they send the patient home to wait for test results in isolation.

The peripheral finding in CT scan can be visualized by lung ultrasound, with high concordance[6]

In memoriam of Prof. Maurizio Galderisi

March 27, 2020

WF joins the whole medical community especially the ultrasound imaging community in remembering Prof. Maurizio Galderisi with sadness who lost his life to COVID-19 recently.

He was a great friend of WINFOCUS and provided valuable help in producing the FoCUS recommendations:

International evidence-based recommendations for focused cardiac ultrasound: Via G, Hussain A, Wells M et al. JASE 2014