Lung ultrasound in the diagnosis of serious lesions caused by the SARS-CoV-2 virus
Keywords:
coronavirus infections, ultrasonography, pneumonia.Abstract
Introduction: Lung ultrasound is a technique that provides very useful information in the diagnostic approach of patients with SARS-CoV-2 virus infection. The infiltrations detected in the pulmonary ultrasound may suggest pulmonary edema, infarction or lobar pneumonia, which offers high availability and the possibility of evaluating the patient in situ. A search was carried out in the engines: Google Scholar, National Library of Medicine PudMed, SciELO regional since 2019. The search strategy used the terms: pulmonary ultrasound / technique, diagnostic methods, pathological findings. In the bibliographic search carried out, 24 articles were found related to pathological findings in lung ultrasound and the diagnostic value of lung lesions.
Objective: To describe the fundamental findings of lung ultrasound in the diagnosis of serious lesions caused by the SARS-CoV-2 virus.
Development: Studies reported similar precision of lung ultrasound compared to chest tomography in detecting lung abnormalities, their relationship to severity status, and risk stratification in critically ill patients with SARS-CoV-2 .
Conclusions: Ultrasound allows a constant and non-invasive evaluation of lung lesions caused by the SARS-CoV-2 virus, allows a correct identification of the severity and its evolution. It is a diagnostic method that reduces the risk of exposure to ionizing radiation, increasing safety for critically ill patients.
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References
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10. Van-Doremalen N, Bushmaker T, Morris DH, Holbrook MG, Gamble A, Williamson BN, et al. Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. N Engl J Med. 2020;382(16):1564-1567. DOI: 10.1056/NEJMc2004973
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17. Volpicelli G, Elbarbary M, Blaivas M, Lichtenstein DA, Mathis G, Kirkpatrick AW, et al. International Liaison Committee on Lung Ultrasound (ILC-LUS) for International Consensus Conference on Lung Ultrasound (ICC-LUS). International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med. 2012; 38(4):577-91. DOI: 10.1007/s00134-012-2513-4
18. Picano E, Scali MC, Ciampi Q, Lichtenstein D. Lung ultrasound for the cardiologist. JACC Cardiovasc Imging. 2018; 11(11):1692-705. DOI: 10.1016/j.jcmg.2018.06.023
19. Salehi S, Abedi A, Balakrishnan S, Gholamrezhad A. Coronavirus Disease 2019 (COVID-19): A systematic review of imaging findings in 919 patients. AJR Am J Roentgenol. 2020; 2015(1):87-93. DOI: 10.2214/AJR.20.23034
20. Lichtenstein DA. BLUE-protocol and FALLS-protocol: two applications of lung ultrasound in the critically ill. Chest. 2015;147(6):1659-1670. DOI: 10.1378/chest.14-1313
21. Cox EGM, Wiersema R, Wong A, van der Horst ICC, SICS Study Group. Six versus eight and twenty-eight scan sites for B-line assessment: differences in examination time and findings. Intensive Care Med. 2020; 46(5):1063-4. DOI: 10.1007/s00134-020-06004-7
22. Poggiali E, Dacrema A, Bastoni D, Tinelli V, Demichele E, Mateo-Ramos P, et al. Can Lung US help critical care clinicians in the early diagnosis of novel coronavirus (COVID-19) pneumonia? Radiology. 2020; 295(3):E6. DOI: 10.1148/radiol.2020200847
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24. Volpicelli G, Lamorte A, Villén T. What's new in lung ultrasound during the COVID-19 pandemic. Int Care Med. 2020; 46(7):1445-8. DOI: 10.1007/s00134-020-06048-9
25. Volpicelli G, Gargani L. Sonographic sign and patterns of COviD-19 neumonia. The Ultrasound Journal 2020; 12(1):22. DOI: 10.1186/s13089-020-00171-w
26. Henriquez C. Utilidad de la ecografía clínica en neumonía vírica por coronavirus. Evidencias en Ecografía Clínica. Especial COVID19; 2020. [acceso: 08/08/2020]:4-11. Disponible en: https://www.fesemi.org/sites/default/files/documentos/grupos/ecografia-/newsletters/evid_ecog_clinica.pdf
27. Huang Y, Wang S, Liu Y, Zhang Y, Zheng C, Zheng Y et al. A Preliminary Study on the Ultrasonic Manifestations of Peri-pulmonary Lesions of Non-Critical Novel Coronavirus Pneu-monia (COVID-19). Rochester, NY: Social Science Research Network; 2020:3544750. DOI: 10.2139/ssrn.3544750
28. Soldati G, Smargiassi A, Inchingolo R, Buonsenso D, Perrone T, Briganti DF, et al. Proposal for international standardization of the use of lung ultrasound for patients with COVID-19: a simple, quantitative, reproducible Method. J Ultrasound Med. 2020; 39(7):1413-9. DOI: 10.1002/jum.15285
29. Soldati G, Demi M, Inchingolo R, Smargiassi A, Demi L. On the Physical Basis of Pulmonary Sonographic Interstitial Syndrome. J Ultrasound Med. 2016; 35(10):2075-86. DOI: 10.7863/ultra.15.08023
30. Pare JR, Camelo I, Leo MM, Dugas JN, Nelson KP, Baker WE, et al. Point-of-care lung ultrasound is more sensitive than chest radiograph for evaluation of COVID-19. West J Emerg Med. 2020; 21(4):771-8. DOI: 10.5811/westjem.2020.5.47743
31. Buonsenso D, Raffaelli F, Tamburrini E, Biasucci D, Salvi S, Smargiassi A, et al. Clinical role of lung ultrasound for the diagnosis and monitoring of COVID-19 pneumonia in pregnant women. Ultrasound Obstet Gynecol. 2020; 56(1):106-9. DOI: 10.1002/uog.22055
32. Wynants L, Calster VB, Collins GS, Riley RD, Heinze G, Schuit E, et al. Prediction models for diagnosis and prognosis ofcovid-19 infection: Systematic review and critical appraisal. BMJ. 2020; 369:m1328. DOI: 1136/bmj.m1328.
33. Vetrugno L, Bove T, Orso D,Barbariol F, Bassi F, Boero E, et al. Our Italian experience using lung ultrasound for identification, grading and serial follow-up of severity of lung involvement for management of patients with COVID-19. Ecocardiography. 2020; 37(4):625-7. DOI: 10.1111/echo.14664
34. Fiala MJ. Ultrasound in COVID-19: a timeline of ultrasound findings in relation to CT. Clin Radiol. 2020; 75(7):553-4. DOI: 10.1016/j.crad.2020.04.003
35. Inchingolo R, Smargiassi A, Moro F, Buonsenso D, Salvi S, Del Giacomo P, Scoppettuolo G, et al. The diagnosis of pneumonia in a pregnant woman with coronavirus disease 2019 using maternal lung ultrasound. Am J Obstet Gynecol. 2020; 223(1):9-11. DOI: 10.1016/j.ajog.2020.04.020
36. Aljondi R, Alghamdi S. Diagnostic value of imaging modalities for COVID-19: scoping review. J Med Internet Res. 2020; 22(8):e19673. DOI: 10.2196/19673
37. Tung-Chen Y, Martí-de-Gracia M, Díez-Tascón A, Alonso-González R, Agudo-Fernández S, et al. Correlation between chest computed tomography and lung ultrasonography in patients with coronavirus disease 2019 (COVID-19). Ultrasound Med Biol. 2020; 46(11):2918-26. DOI: 10.1016/j.ultrasmedbio.2020.07.003
38. Lieveld AW, Kok B, Schuit FH, Azijli K, Heijmans J, Laarhoven A, et al. Diagnosing COVID-19 pneumonia in a pandemic setting: Lung Ultrasound versus CT (LUVCT) A multi-centre, prospective, observational study. ERJ Open Res. 2020; 6(4):00539-2020. DOI: 10.1183/23120541.00539-2020
39. Brahier T, Meuwly JY, Pantet O, Brochu MJ, Gerhard H, Hartley MA, et al. Lung ultrasonography for risk stratification in patients with COVID-19: a prospective observational cohort study. Clinical Infectious Diseases, 2020; 73(11):e4189-e4196. DOI: 10.1093/cid/ciaa1408
40. Litcher Y, Topilsky Y, Taieb P, Banai A, Hochstadt A, Merdler LL, et al. Lung ultrasound predicts clinical course and outcomes in COVID-19 patients. Intensive Care Medicine. 2020; 46:1873-1883. DOI: 10.1007/s00134-020-06212-1
41. Xing Ch, Li Q, Du H, Kang W, Lian J, Yuan L. Lung ultrasound findings in patients with COVID-19 pneumonia. Critical Care. 2020; 24(1):174. DOI: 10.1186/s13054-020-02876-9
42. Zotzmann V, Lang CN, Bamberg F, Bode C, Staudacher DL. Are subpleural consolidations indicators for segmental pulmonary embolism in COviD-19? intensive Care Med. 2020; 46(6):1109-10. DOI: 10.1007/s00134-020-06044-z
43. Buonsenso D, Piano A, Raffaelli F, Bonadia N. Point of-care lung ultrasound findings in novel coronavirus disease-19 pnemoniae: a case report and potential applications during COVID-19 outbreak. Eur Rev Med Pharmacol Sci. 2020; 24(5):2776-80. DOI: 10.26355/eurrev_202003_20549
44. Cho Y, Song K, Lee Y, Yoon JH, Park JY, Jung J, et al. Lung ultrasound for early diagnosis and severity assessment of pneumonia in patients with coronavirus disease 2019. Korean J Intern Med. 2020; 35(4):771-81. DOI: 10.3904/kjim.2020.180
45. Bai HX, Hsieh B, Xiong Z, Halsey K, Choi JW, Tran TML, et al. Performance of radiologists in differentiating COVID-19 from viral pneumonia on chest CT. Radiology. 2020; 296(2):E46-54. DOI: 10.1148/radiol.2020200823
46. Prokop M, Everdingen W Van, Rees T Van, Ufford JQ Van, Geurts B, Krdzalic J, et al. CO-RADS: a categorical CT assessment scheme for patients with suspected COVID-19-definition and evaluation. Radiology. 2020; 296(2):E97-104. DOI: 10.1148/radiol.2020201473
47. Ministerio de Salud Pública. Protocolo de actuación nacional para la Covid-19. Versión 1.6. 2021. La Habana, Cuba: Minsap; 2021. [acceso: 06/08/2022]. Disponible en: https://files.sld.cu/editorhome/files/2021/03/Protocolo-COVID19-Cuba_versi%C3%B3n-1.6.pdf
2. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J et al. A Novel Coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020; 382:727-33. DOI: 10.1056/NEJMoa2001017
3. Sofia S, Boccatonda A, Montanari M, Spampinato M, D'Ardes D, Cocco G, et al. Thoracic ultrasound and SARS-COVID-19: a pictorial essay. Journal of ultrasound. 2020; 23(2):217-21. DOI: 10.1007/s40477-020-00458-7
4. Wong J, Goh QY, Tan Z, Lie SA, Tay YC, Ng SY, et al. Preparing for a COVID-19 pandemic: a review of operating room outbreak response measures in a large tertiary hospital in Singapore. Can J Anaesth. 2020; 67(6):732-45. DOI: 10.1007/s12630-020-01620-9
5. Cuba. Centro Nacional de Información de Ciencias Médicas. Biblioteca Médica Nacional. Epidemiología y la COVID-19: Mujeres y hombres. Estadísticas Mundiales. Factográfico salud. 2022 [acceso: 13/08/2022]; 8(6):[aprox. 18 p.]. Disponible en: http://files.sld.cu/bmn/files/2022/06/factografico-de-salud-junio-2022.pdf
6. Mayo PH, Copetti R, Feller-Kopman D, Mathis G, Maury E, Mongodi S, et al. Thoracic ultrasonography: a narrative review. Intensive Care Med. 2019; 45(9):1200-11. DOI: 10.1007/s00134-019-05725-8
7. Sikachi R, Agrawal A. Whole body point-care ultrasound for COVID‐19: a multisystem approach to a multi‐system disease. Anaesthesia. 2020; 75(8):1114-1115. DOI: 10.1111/anae.15087
8. Smith MJ, Hayward SA, Innes SM, Miller A. Point-of-care lung ultrasound in patients with COVID-19 - a narrative review. Anaesthesia. 2020; 75(8):1096-1104 DOI: 10.1111/anae.15082
9. Kalafat E,Yaprak E, Cinar G, Varli B, Ozisik S, Uzun C, et al. Lung ultrasound and computed tomographic findings in pregnant woman with COVID-19. Ultrasound Obstet Gynecol. 2020; 55(6):835-7. DOI: 10.1002/uog.22034
10. Van-Doremalen N, Bushmaker T, Morris DH, Holbrook MG, Gamble A, Williamson BN, et al. Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. N Engl J Med. 2020;382(16):1564-1567. DOI: 10.1056/NEJMc2004973
11. Soldati G, Smargiassi A, Inchingolo R, Buonsenso D, Perrone T, Federica D, et al. Is There a Role for Lung Ultrasound During the COVID-19 Pandemic? J Ultrasound Med. 2020; 39(7):1459-1462. DOI: 10.1002/jum.15284
12. Leiva-Cepas F, Romero-Rodríguez E, Barroso Sevillano M. Las revistas científicas ante la pandemia por COVID-19. Semergen. 2020; 46(S1):1-2. DOI: 10.1016/j.semerg.2020.06.012
13. Zayas-Mujica R, Madero-Durán S, Rodríguez-Alonso B, Alfonso-Manzanet JE. Producción científica sobre la COVID-19 en revistas médicas cubanas a 90 días del inicio de la pandemia. Rev haban cienc méd. 2020 [acceso: 08/08/2020]; 19(4):1-15. Disponible en: http://www.revhabanera.sld.cu/index.php/rhab/article/view/3576
14. Raheja R, Brahmavar M, Joshi D, Raman D. Application of lung ultrasound in critical care setting: a review. Cureus. 2019; 11(7):e5233. DOI: 10.7759/cureos.5233
15. Peng QY, Wang XT, Zhang LN. Chinese Critical Care Ultrasound Study Group (CCUSG). Findings of lung ultrasonography of novel corona virus pneumonia during the 2019-2020 epidemic. Intensive Care Med. 2020; 46(5):849-50. DOI: 10.1007/s00134-020-05996-6
16. Perrone T, Maggi A, Sgarlata C, Palumbo I, Mossolani E, Ferrari S, et al. Lung ultrasound in internal medicine: A bedside helps to increase accuracy in the diagnosis of dyspnea. Eur J Intern Med. 2017; 46:61-65. DOI: 10.1007/s12630-020-01620-9
17. Volpicelli G, Elbarbary M, Blaivas M, Lichtenstein DA, Mathis G, Kirkpatrick AW, et al. International Liaison Committee on Lung Ultrasound (ILC-LUS) for International Consensus Conference on Lung Ultrasound (ICC-LUS). International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med. 2012; 38(4):577-91. DOI: 10.1007/s00134-012-2513-4
18. Picano E, Scali MC, Ciampi Q, Lichtenstein D. Lung ultrasound for the cardiologist. JACC Cardiovasc Imging. 2018; 11(11):1692-705. DOI: 10.1016/j.jcmg.2018.06.023
19. Salehi S, Abedi A, Balakrishnan S, Gholamrezhad A. Coronavirus Disease 2019 (COVID-19): A systematic review of imaging findings in 919 patients. AJR Am J Roentgenol. 2020; 2015(1):87-93. DOI: 10.2214/AJR.20.23034
20. Lichtenstein DA. BLUE-protocol and FALLS-protocol: two applications of lung ultrasound in the critically ill. Chest. 2015;147(6):1659-1670. DOI: 10.1378/chest.14-1313
21. Cox EGM, Wiersema R, Wong A, van der Horst ICC, SICS Study Group. Six versus eight and twenty-eight scan sites for B-line assessment: differences in examination time and findings. Intensive Care Med. 2020; 46(5):1063-4. DOI: 10.1007/s00134-020-06004-7
22. Poggiali E, Dacrema A, Bastoni D, Tinelli V, Demichele E, Mateo-Ramos P, et al. Can Lung US help critical care clinicians in the early diagnosis of novel coronavirus (COVID-19) pneumonia? Radiology. 2020; 295(3):E6. DOI: 10.1148/radiol.2020200847
23. Pérez-Pallarés J coordinador. Manual SEPAR de procedimientos 33. Ecografía torácica Volumen 2. Barcelona: Editorial Respira; 2017. [acceso: 08/08/2020]. https://issuu.com/separ/docs/manual_separ_33_de_ecografi__a_tora_-5c8251a77dd8e0
24. Volpicelli G, Lamorte A, Villén T. What's new in lung ultrasound during the COVID-19 pandemic. Int Care Med. 2020; 46(7):1445-8. DOI: 10.1007/s00134-020-06048-9
25. Volpicelli G, Gargani L. Sonographic sign and patterns of COviD-19 neumonia. The Ultrasound Journal 2020; 12(1):22. DOI: 10.1186/s13089-020-00171-w
26. Henriquez C. Utilidad de la ecografía clínica en neumonía vírica por coronavirus. Evidencias en Ecografía Clínica. Especial COVID19; 2020. [acceso: 08/08/2020]:4-11. Disponible en: https://www.fesemi.org/sites/default/files/documentos/grupos/ecografia-/newsletters/evid_ecog_clinica.pdf
27. Huang Y, Wang S, Liu Y, Zhang Y, Zheng C, Zheng Y et al. A Preliminary Study on the Ultrasonic Manifestations of Peri-pulmonary Lesions of Non-Critical Novel Coronavirus Pneu-monia (COVID-19). Rochester, NY: Social Science Research Network; 2020:3544750. DOI: 10.2139/ssrn.3544750
28. Soldati G, Smargiassi A, Inchingolo R, Buonsenso D, Perrone T, Briganti DF, et al. Proposal for international standardization of the use of lung ultrasound for patients with COVID-19: a simple, quantitative, reproducible Method. J Ultrasound Med. 2020; 39(7):1413-9. DOI: 10.1002/jum.15285
29. Soldati G, Demi M, Inchingolo R, Smargiassi A, Demi L. On the Physical Basis of Pulmonary Sonographic Interstitial Syndrome. J Ultrasound Med. 2016; 35(10):2075-86. DOI: 10.7863/ultra.15.08023
30. Pare JR, Camelo I, Leo MM, Dugas JN, Nelson KP, Baker WE, et al. Point-of-care lung ultrasound is more sensitive than chest radiograph for evaluation of COVID-19. West J Emerg Med. 2020; 21(4):771-8. DOI: 10.5811/westjem.2020.5.47743
31. Buonsenso D, Raffaelli F, Tamburrini E, Biasucci D, Salvi S, Smargiassi A, et al. Clinical role of lung ultrasound for the diagnosis and monitoring of COVID-19 pneumonia in pregnant women. Ultrasound Obstet Gynecol. 2020; 56(1):106-9. DOI: 10.1002/uog.22055
32. Wynants L, Calster VB, Collins GS, Riley RD, Heinze G, Schuit E, et al. Prediction models for diagnosis and prognosis ofcovid-19 infection: Systematic review and critical appraisal. BMJ. 2020; 369:m1328. DOI: 1136/bmj.m1328.
33. Vetrugno L, Bove T, Orso D,Barbariol F, Bassi F, Boero E, et al. Our Italian experience using lung ultrasound for identification, grading and serial follow-up of severity of lung involvement for management of patients with COVID-19. Ecocardiography. 2020; 37(4):625-7. DOI: 10.1111/echo.14664
34. Fiala MJ. Ultrasound in COVID-19: a timeline of ultrasound findings in relation to CT. Clin Radiol. 2020; 75(7):553-4. DOI: 10.1016/j.crad.2020.04.003
35. Inchingolo R, Smargiassi A, Moro F, Buonsenso D, Salvi S, Del Giacomo P, Scoppettuolo G, et al. The diagnosis of pneumonia in a pregnant woman with coronavirus disease 2019 using maternal lung ultrasound. Am J Obstet Gynecol. 2020; 223(1):9-11. DOI: 10.1016/j.ajog.2020.04.020
36. Aljondi R, Alghamdi S. Diagnostic value of imaging modalities for COVID-19: scoping review. J Med Internet Res. 2020; 22(8):e19673. DOI: 10.2196/19673
37. Tung-Chen Y, Martí-de-Gracia M, Díez-Tascón A, Alonso-González R, Agudo-Fernández S, et al. Correlation between chest computed tomography and lung ultrasonography in patients with coronavirus disease 2019 (COVID-19). Ultrasound Med Biol. 2020; 46(11):2918-26. DOI: 10.1016/j.ultrasmedbio.2020.07.003
38. Lieveld AW, Kok B, Schuit FH, Azijli K, Heijmans J, Laarhoven A, et al. Diagnosing COVID-19 pneumonia in a pandemic setting: Lung Ultrasound versus CT (LUVCT) A multi-centre, prospective, observational study. ERJ Open Res. 2020; 6(4):00539-2020. DOI: 10.1183/23120541.00539-2020
39. Brahier T, Meuwly JY, Pantet O, Brochu MJ, Gerhard H, Hartley MA, et al. Lung ultrasonography for risk stratification in patients with COVID-19: a prospective observational cohort study. Clinical Infectious Diseases, 2020; 73(11):e4189-e4196. DOI: 10.1093/cid/ciaa1408
40. Litcher Y, Topilsky Y, Taieb P, Banai A, Hochstadt A, Merdler LL, et al. Lung ultrasound predicts clinical course and outcomes in COVID-19 patients. Intensive Care Medicine. 2020; 46:1873-1883. DOI: 10.1007/s00134-020-06212-1
41. Xing Ch, Li Q, Du H, Kang W, Lian J, Yuan L. Lung ultrasound findings in patients with COVID-19 pneumonia. Critical Care. 2020; 24(1):174. DOI: 10.1186/s13054-020-02876-9
42. Zotzmann V, Lang CN, Bamberg F, Bode C, Staudacher DL. Are subpleural consolidations indicators for segmental pulmonary embolism in COviD-19? intensive Care Med. 2020; 46(6):1109-10. DOI: 10.1007/s00134-020-06044-z
43. Buonsenso D, Piano A, Raffaelli F, Bonadia N. Point of-care lung ultrasound findings in novel coronavirus disease-19 pnemoniae: a case report and potential applications during COVID-19 outbreak. Eur Rev Med Pharmacol Sci. 2020; 24(5):2776-80. DOI: 10.26355/eurrev_202003_20549
44. Cho Y, Song K, Lee Y, Yoon JH, Park JY, Jung J, et al. Lung ultrasound for early diagnosis and severity assessment of pneumonia in patients with coronavirus disease 2019. Korean J Intern Med. 2020; 35(4):771-81. DOI: 10.3904/kjim.2020.180
45. Bai HX, Hsieh B, Xiong Z, Halsey K, Choi JW, Tran TML, et al. Performance of radiologists in differentiating COVID-19 from viral pneumonia on chest CT. Radiology. 2020; 296(2):E46-54. DOI: 10.1148/radiol.2020200823
46. Prokop M, Everdingen W Van, Rees T Van, Ufford JQ Van, Geurts B, Krdzalic J, et al. CO-RADS: a categorical CT assessment scheme for patients with suspected COVID-19-definition and evaluation. Radiology. 2020; 296(2):E97-104. DOI: 10.1148/radiol.2020201473
47. Ministerio de Salud Pública. Protocolo de actuación nacional para la Covid-19. Versión 1.6. 2021. La Habana, Cuba: Minsap; 2021. [acceso: 06/08/2022]. Disponible en: https://files.sld.cu/editorhome/files/2021/03/Protocolo-COVID19-Cuba_versi%C3%B3n-1.6.pdf
Published
2023-02-08
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Cuba Naranjo AJ, Sosa A, Cabrales Barbán A. Lung ultrasound in the diagnosis of serious lesions caused by the SARS-CoV-2 virus. Rev Cubana Med Milit [Internet]. 2023 Feb. 8 [cited 2025 Jan. 30];52(1):e02302252. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/2252
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