COVID-19

Lessons of the month 1: A case of rhombencephalitis as a rare complication of acute COVID-19 infection (2020)

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Type of publication:
Journal article

Author(s):
*Po Fung Wong, *Sam Craik, *Piers Newman, *Annabel Makan, *Koottalai Srinivasan, *Emma Crawford, *Devapriya Dev, *Harmesh Moudgil and *Nawaid Ahmad

Citation:
Clinical Medicine 2020 Vol 20, No 3, p. 293-294

Abstract:
A 40-year-old man developed acute brainstem dysfunction 3 days after hospital admission with symptoms of the novel SARS-CoV-2 infection (COVID-19). Magnetic resonance imaging showed changes in keeping with inflammation of the brainstem and the upper cervical cord, leading to a diagnosis of rhombencephalitis. No other cause explained the patient’s abnormal neurological findings. He was managed conservatively with rapid spontaneous improvement in some of his neurological signs and was discharged home with continued neurology follow up.

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Point-of-care lung ultrasound in patients with COVID-19 - a narrative review (2020)

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Type of publication:
Journal article

Author(s):
Smith, M J; Hayward, S A; Innes, S M; *Miller, A S C

Citation:
Anaesthesia; Aug 2020, vol. 75 (no. 8); p. 1096-1104

Abstract:
Ultrasound imaging of the lung and associated tissues may play an important role in the management of patients with COVID-19-associated lung injury. Compared with other monitoring modalities, such as auscultation or radiographic imaging, we argue lung ultrasound has high diagnostic accuracy, is ergonomically favourable and has fewer infection control implications. By informing the initiation, escalation, titration and weaning of respiratory support, lung ultrasound can be integrated into COVID-19 care pathways for patients with respiratory failure. Given the unprecedented pressure on healthcare services currently, supporting and educating clinicians is a key enabler of the wider implementation of lung ultrasound. This narrative review provides a summary of evidence and clinical guidance for the use and interpretation of lung ultrasound for patients with moderate, severe and critical COVID-19-associated lung injury. Mechanisms by which the potential lung ultrasound workforce can be deployed are explored, including a pragmatic approach to training, governance, imaging, interpretation of images and implementation of lung ultrasound into routine clinical practice.

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