Validation of Remote Dielectric Sensing (ReDS) in Monitoring Adult Patients Affected by COVID-19 Pneumonia.

Federico Mei,Lina Zuccatosta,Martina Bonifazi,Lara Letizia Latini,Stefano Gasparini,Alessandro Di Marco Berardino

doi:10.3390/diagnostics11061003

Abstract

Remote dielectric sensing (ReDS) is a non-invasive electromagnetic wave technology which provides an accurate reading of lung fluid content, and it has been reported as a valid tool in monitoring heart failure patients. Considering that morphological alterations in COVID-19 include pulmonary edema, the purpose of the present study was to evaluate the reliability of ReDS technology in assessing the excess of lung fluid status in COVID-19 pneumonia, as compared to CT scans. In this pilot single center study, confirmed COVID-19 patients were enrolled on admission to an intermediate care unit. Measurements with the ReDS system and CT scans were performed on admission and at weeks 1 and 2. Eleven patients were recruited. The average change in ReDS was −3.1 ± 1.7 after one week (p = 0.001) and −4.6 ± 2.9 after two weeks (p = 0.006). A similar trend was seen in total CT score (−3.3 ± 2.1, p = 0.001). The level of agreement between ReDS and CT changes yielded a perfect result. Statistically significant changes were observed in lactate dehydrogenase, lymphocytes, and c-reactive protein over 2 weeks. This pilot study shows that ReDS can track changes in lung involvement according to the severity of COVID-19. Further studies to detect early clinical deterioration are needed.

Highlights

In December of 2019, an outbreak of a novel coronavirus disease (COVID-19) occurred in Wuhan, a city in the Chinese province of Hubei, and, thereafter, it dramatically spread worldwide [1,2,3,4,5,6]
COVID-19 can present with a wide spectrum of clinical manifestations, ranging from mild or no symptoms (80%) to severe pneumonia with acute respiratory distress syndrome (ARDS) (20%) [2]
D-dimer, LDH, and CRP were altered in most of the study cohort (599.3 ± 873.4 mg/dL, 321.45 ± 103.6 U/L, 4.7 ± 4.3 mg/dL mean values, respectively), while BNP was normal for all patients

Summary

Introduction

In December of 2019, an outbreak of a novel coronavirus disease (COVID-19) occurred in Wuhan, a city in the Chinese province of Hubei, and, thereafter, it dramatically spread worldwide [1,2,3,4,5,6]. COVID-19 can present with a wide spectrum of clinical manifestations, ranging from mild or no symptoms (80%) to severe pneumonia with acute respiratory distress syndrome (ARDS) (20%) [2]. Pathological features include diffuse alveolar damage, proteinaceous exudate, focal reactive hyperplasia of pneumocytes with patchy inflammatory cellular infiltration, and progressive extracellular lung water collection, leading to pulmonary edema. Chest computed tomography (CT) is crucial to assess the pattern as well as extent of lung lesions, and the most common radiological pictures include pure “ground-glass” opacities (GGO), GGO with reticular and/or interlobular septal thickening, GGO with consolidations, crazy paving, and pure consolidations [13,14,15]. Different CT features are associated with patient prognosis, with mixed patterns being more common in severe cases with poor outcomes [13,16].

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