ULTRACOV

ULTRACOV: Novel ultrasound scanner to face COVID-19 disease challenges: early diagnosis and following of patients evolution.

This project obtained funding from the las call of the Spanish Institution “CDTI” (July 2020) in a very competitive call for R&D projects to face the health emergency COVID19. ULTRACOV  This development is led by DASEL SL, a Madrid SME based in Arganda del Rey. The Ultrasonic Systems and Technologies Group of the CSIC (GSTU-CSIC) and the Nuclear Physics Group Group of the Complutense University of Madrid (GFN-UCM) will also participate. The participation of the emergency ultrasound service of the Hospital Universitario La Paz guarantees the clinical approach at all stages of the development of the ultrasound system, and will carry out the first trials with patients.

The project duration is 18 months, (starting July 2020) and clinical trials of the prototype are planned to begin in early 2021.

Background:

There is a consensus that lung ultrasound at the patient bedside is a valuable tool for diagnosis and monitoring in patients suffering from COVID-19, as it is safe, very specific and can be performed at the bedside of the patient. However, this is a technique that is not yet very widespread, mainly because the interpretation of lung images is complex and because of the lack of personnel properly trained. Furthermore, in a pandemic context, ultrasound with conventional equipment involves a higher risk of contagion for the examiner than other techniques such as chest radiography and computed tomography. For these reasons, it would be essential to minimize the duration of the examination and simplify its execution.

Objective:

The objective of the ULTRACOV project is the development of an ultrasound scanner oriented to the early detection and monitoring of the COVID-19 disease, specially designed for situations of pandemic and high healthcare pressure. Through interactive artificial intelligence tools that simplify the examination and interpretation of images, and a design oriented to operation in high-risk conditions (easy disinfection, ergonomics, etc.), the aim is to extend lung ultrasound to a greater number of professionals and services, from primary care to intensive care. The impact on the capacity of the healthcare system for the management of COVID-19 patients would be very positive, since it is a very specific tool for evaluating the lung condition at all stages of the disease, including potential chronic problems. in the medium and long term. Furthermore, it would be useful for the diagnosis and management of patients with other lung pathologies, potentially serious in certain groups (pediatric patients, pregnant patients, etc.).

The specific objectives are:

– Extend the use of lung ultrasound to all levels of care and, in particular, to primary care services.

– Reduce exam time and simplify its performance with two objectives: Maximize the number of exams performed in situations of high healthcare pressure, and minimize the risk of contagion by the examiner.

– Improve and simplify the equipment disinfection process.

– Generalize the registration of images, in order to facilitate the monitoring of patients and to generate databases that can be used to study the disease and to develop the technique itself.

Impact

We have identified various scenarios where ULTRACOV could help improve the alert situation due to COVID-19:

Primary care:

Having lung ultrasound as a diagnostic tool in the early stages of the disease is essential to improve patient management. In particular, it will allow a better decision to be made between home confinement or hospital admission for patients with mild symptoms, based on the real risk of developing pneumonia imminently.

Hospital emergency

We hope that professionals at this level of care will benefit from ULTRACOV in two aspects: The simplicity of handling and evaluating the images will reduce the examination time (even for expert personnel), reducing the work pressure and the probability of contagion for this group. On the other hand, its design oriented towards ease of disinfection will also reduce the risk of contagion, both for the examiner, the patient and auxiliary personnel, and will facilitate its use within clean / dirty circuits.

Hospitalization

A patient’s bedside lung ultrasound is a very valuable monitoring tool for patients with COVID-19: It offers very specific information for monitoring the disease, it can be completed in minutes and it is harmless (it does not use ionizing radiation). Also in this area, its ease of use will allow more healthcare professionals to be trained quickly in lung ultrasound, and to improve patient follow-up thanks to the definition of examination protocols and self-saving of data.

Intensive care units

Computed tomography (CT) is the reference imaging method for evaluating lung involvement in patients with COVID-19. However, it has multiple contraindications, either relative, such as its use in pregnant or infant population, or absolute, in unstable patients, generally admitted to intensive care units, since it requires transfer to the tomograph. Therefore, also in intensive care units, the patient’s bedside lung ultrasound is very useful for its management, allowing an agile and continuous evaluation of the level of lung involvement. In this context, the ability of ULTRACOV to define individualized examination protocols and self-save the acquired images will facilitate the monitoring of patients, being able to review cases centrally and not only at the patient’s bedside as at present.

Investigation and development.

Currently, lung ultrasounds is not usually stored or incorporated into hospital databases, as they are bedside examinations performed by on-site professionals. Once the potential of this technique has been seen in the diagnosis and management of COVID-19 patients, the lack of reference images and databases is being a serious limitation both for the development of new technologies and for the study of the disease. The definition of individualized examination protocols and the possibility of saving the images acquired automatically without the intervention of the examiner, will have a very positive impact on the generation of databases for research into the disease and the development of new tools.

In summary, we believe that the development of an intelligent lung ultrasound tool will have a positive impact at all levels of care, and will improve the position of the national health system to face this pandemic and future outbreaks. In the medium and long term, the generalization of lung ultrasound in primary care and emergencies will also have a positive impact on the management of other respiratory pathologies.