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Role of Lung Ultrasound in Predicting Clinical Severity and Fatality in COVID-19 Pneumonia.

ABSTRACT: Lung ultrasound (LUS) is a useful imaging method for identifying COVID-19 pneumonia. The aim of this study was to explore the role of LUS in predicting the severity of the disease and fatality in patients with COVID-19. This was a single-center, follow-up study, conducted from 1 November 2020, to 22 March 2021. The LUS protocol was based on the assessment of 14 lung zones with a total score up to 42, which was compared to the disease severity and fatality. A total of 133 patients with COVID-19 pneumonia confirmed by RT-PCR were enrolled, with a median time from hospital admission to lung ultrasound of one day. The LUS score was correlated with clinical severity at hospital admission (Spearman's rho 0.40, 95% CI 0.24 to 0.53, p < 0.001). Patients with higher LUS scores were experiencing greater disease severity; a high flow nasal cannula had an odds ratio of 1.43 (5% CI 1.17-1.74) in patients with LUS score > 29; the same score also predicted the need for mechanical ventilation (1.25, [1.07-1.48]). An LUS score > 30 (1.41 [1.18-1.68]) and age over 68 (1.26 [1.11-1.43]) were significant predictors of fatality. LUS at hospital admission is shown to have a high predictive power of the severity and fatality of COVID-19 pneumonia.

SUBMITTER: Skopljanac I

PROVIDER: S-EPMC8399683 | biostudies-literature | 2021 Jul

REPOSITORIES: biostudies-literature

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Role of Lung Ultrasound in Predicting Clinical Severity and Fatality in COVID-19 Pneumonia.

Skopljanac Ivan I Ivelja Mirela Pavicic MP Barcot Ognjen O Brdar Ivan I Dolic Kresimir K Polasek Ozren O Radic Mislav M

Journal of personalized medicine 20210730 8

<h4>Background</h4>Lung ultrasound (LUS) is a useful imaging method for identifying COVID-19 pneumonia. The aim of this study was to explore the role of LUS in predicting the severity of the disease and fatality in patients with COVID-19.<h4>Methods</h4>This was a single-center, follow-up study, conducted from 1 November 2020, to 22 March 2021. The LUS protocol was based on the assessment of 14 lung zones with a total score up to 42, which was compared to the disease severity and fatality.<h4>Re ...[more]

PMID: 34442401

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Project description:BackgroundChest radiography (CXR) and computerized tomography (CT) are the standard methods for lung imaging in diagnosing COVID-19 pneumonia in the intensive care unit (ICU), despite their limitations. This study aimed to assess the performance of bedside lung ultrasound examination by a critical care physician for the diagnosis of COVID-19 pneumonia during acute admission to the ICU.MethodThis was an observational, prospective, single-center study conducted in the intensive care unit of Adan General Hospital from April 10, 2020, to May 26, 2020. The study included adults with suspicion of COVID-19 Infection who were transferred to the ICU. Patients were admitted to the ICU directly from the ED after reverse transcriptase-polymerase chain reaction (RT-PCR) swabs were sent to the central virology laboratory in Kuwait, and the results were released 16 to 24 hours after the time of admission. A certified intensivist in critical care ultrasound performed the lung ultrasound within 12 hours of the patient's admission to the ICU.The treating physician confirmed the diagnosis of COVID-19 pneumonia based on a set of clinical features, inflammatory markers, biochemical profile studies, RT-PCR test results, and CXR.ResultsOf 77 patients with suspected COVID-19 pneumonia, 65 (84.4%) were confirmed. The median age of the patients was 48 (31-68) years, and 51 (71%) were men.In the group of patients with confirmed COVID-19 pneumonia, LUS revealed four signs suggestive of COVID-19 pneumonia in 63 patients (96.9%) (sensitivity 96.9%, CI 85%-99.5%). Two patients presented with unilateral lobar pneumonia without other ultrasonic signs of COVID-19 pneumonia but with positive RT-PCR results. Among patients in the group without COVID-19 pneumonia who had negative RT-PCR results, 11 (91.7%) were LUS negative for COVID-19 pneumonia (specificity 91.7%, 95% CI 58.72%-99.77%).ConclusionsDuring the COVID-19 outbreak, LUS allows the identification of early signs of interstitial pneumonia. LUS patterns that show a combination of the four major signs offer high sensitivity and specificity compared to nasopharyngeal RT-PCR.

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Role of Lung Ultrasound in Predicting Clinical Severity and Fatality in COVID-19 Pneumonia.

Publications

Role of Lung Ultrasound in Predicting Clinical Severity and Fatality in COVID-19 Pneumonia.

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