Table 1.
Correlation of respiratory support with findings on imaging and outcomes
| Subject | 1 | 2 | 3 | 4 |
|---|---|---|---|---|
| Respiratory support | High-flow nasal canula | Mechanical ventilation VC (AC) via endotracheal tube | ||
| FiO2 | 0.6 | 0.7 | 1.0 | 1.0 |
| Flow (l/min) | 60 | 60 | – | – |
| PEEP (cmH2O) | – | – | 10 | 10 |
| Tidal volume set/achieved (ml) | – | – | 370/374 | 330/265 |
| Peak airway pressure (cmH2O) | – | – | 34 | 32 |
| Dynamic compliance (ml/cmH2O) | – | – | 15.6 | 12 |
| SpO2 | 88% | 89% | 98% | 97% |
| PaO2/FiO2 | 111 | 61 | 64 | 82 |
| Lung ultrasound score | 22 | 20 | 17 | 20 |
| Lung ultrasound findings | Interstitial syndrome with pleural line thickening and irregularities, in all 12 zones, with light beams, and bilateral patchy areas with small peripheral consolidations | |||
| Left lobar consolidation, and moderate left pleural effusion | Bibasal atelectasis | |||
| DVT ultrasound | Negative | Negative | Negative | Negative |
| Echocardiography | Normal | Normal | Dilated RV with impaired function | Normal |
| Saline microbubble contrast study | Negative | Grade 2 interatrial shunt | Grade 4 interatrial shunt | Grade 3 intrapulmonary shunt |
| Day of imaging (after admission) | Day 9 | Day 8 | Day 14 | Day 14 |
| COVID-19 phenotype | H (high elastance) | H (high elastance) | ||
| Outcome | Discharged home Day 17 | Intubated Day 10, discharged home Day 39 | Death Day 17 | Death Day 16 |
Shunt grading: grade 1: < 5 bubbles; grade 2: 5 to 25 bubbles; grade 3: > 25 bubbles; and grade 4: opacification of chamber [10]. DVT deep vein thrombosis, PEEP positive end expiratory pressure, RV right ventricle, VC (AC) volume control (assist control). Phenotypes of COVID-19 have been described: L (low elastance) and H (high elastance)