tetano
Editor, Senior Moderator
Respir Care
. 2021 May 18;respcare.08648.
doi: 10.4187/respcare.08648. Online ahead of print.
Lung Ultrasound Score to Predict Outcomes in COVID-19
Pere Trias-Sabri?[SUP] 1 2 [/SUP], Maria Molina-Molina[SUP] 1 2 [/SUP], Samantha Aso[SUP] 1 [/SUP], Marta Hern?ndez Argudo[SUP] 1 [/SUP], Marta Diez-Ferrer[SUP] 1 [/SUP], Joan Sabater[SUP] 3 [/SUP], Jordi Dorca[SUP] 1 2 [/SUP], Salud Santos[SUP] 1 2 [/SUP], Guillermo Suarez-Cuartin[SUP] 4 [/SUP]
Affiliations
Abstract
Background: Patients with coronavirus disease 2019 (COVID-19) can develop severe bilateral pneumonia leading to respiratory failure. We aimed to study the potential role of lung ultrasound score (LUS) in subjects with COVID-19.
Methods: We conducted an observational, prospective pilot study, including consecutive subjects admitted to an intermediate care unit due to COVID-19 pneumonia. LUS is a 12-zone examination method for lung parenchyma assessment. LUS was performed with a portable convex transducer, scores from 0 to 36 points. Clinical and demographic data were collected at LUS evaluation. Survival analysis was performed using a composite outcome including ICU admission or death. Subjects were followed for 30 d from LUS assessment.
Results: Of 36 subjects included, 69.4% were male, and mean age was 60.19 ? 12.75 y. A cutoff LUS ? 24 points showed 100% sensitivity, 69.2% specificity, and an area under the receiver operating characteristic curve of 0.85 for predicting worse prognosis. The composite outcome was present in 10 subjects (55.6%) with LUS ? 24 points, but not in the group with lower LUS scores (P < .001). Subjects with LUS ? 24 points had a higher risk of ICU admission or death (hazard ratio 9.97 [95% CI 2.75-36.14], P < .001). Significant correlations were observed between LUS and S[SUB]pO[SUB]2[/SUB][/SUB] /F[SUB]IO[SUB]2[/SUB][/SUB] , serum D-dimer, C-reactive protein, lactate dehydrogenase, and lymphocyte count.
Conclusions: LUS ? 24 points can help identify patients with COVID-19 who are likely to require ICU admission or to die during follow-up. LUS also correlates significantly with clinical and laboratory markers of COVID-19 severity.
Keywords: ARDS; COVID-19; ICU; intermediate respiratory care unit; lung ultrasound; pneumonia.
. 2021 May 18;respcare.08648.
doi: 10.4187/respcare.08648. Online ahead of print.
Lung Ultrasound Score to Predict Outcomes in COVID-19
Pere Trias-Sabri?[SUP] 1 2 [/SUP], Maria Molina-Molina[SUP] 1 2 [/SUP], Samantha Aso[SUP] 1 [/SUP], Marta Hern?ndez Argudo[SUP] 1 [/SUP], Marta Diez-Ferrer[SUP] 1 [/SUP], Joan Sabater[SUP] 3 [/SUP], Jordi Dorca[SUP] 1 2 [/SUP], Salud Santos[SUP] 1 2 [/SUP], Guillermo Suarez-Cuartin[SUP] 4 [/SUP]
Affiliations
- PMID: 34006594
- DOI: 10.4187/respcare.08648
Abstract
Background: Patients with coronavirus disease 2019 (COVID-19) can develop severe bilateral pneumonia leading to respiratory failure. We aimed to study the potential role of lung ultrasound score (LUS) in subjects with COVID-19.
Methods: We conducted an observational, prospective pilot study, including consecutive subjects admitted to an intermediate care unit due to COVID-19 pneumonia. LUS is a 12-zone examination method for lung parenchyma assessment. LUS was performed with a portable convex transducer, scores from 0 to 36 points. Clinical and demographic data were collected at LUS evaluation. Survival analysis was performed using a composite outcome including ICU admission or death. Subjects were followed for 30 d from LUS assessment.
Results: Of 36 subjects included, 69.4% were male, and mean age was 60.19 ? 12.75 y. A cutoff LUS ? 24 points showed 100% sensitivity, 69.2% specificity, and an area under the receiver operating characteristic curve of 0.85 for predicting worse prognosis. The composite outcome was present in 10 subjects (55.6%) with LUS ? 24 points, but not in the group with lower LUS scores (P < .001). Subjects with LUS ? 24 points had a higher risk of ICU admission or death (hazard ratio 9.97 [95% CI 2.75-36.14], P < .001). Significant correlations were observed between LUS and S[SUB]pO[SUB]2[/SUB][/SUB] /F[SUB]IO[SUB]2[/SUB][/SUB] , serum D-dimer, C-reactive protein, lactate dehydrogenase, and lymphocyte count.
Conclusions: LUS ? 24 points can help identify patients with COVID-19 who are likely to require ICU admission or to die during follow-up. LUS also correlates significantly with clinical and laboratory markers of COVID-19 severity.
Keywords: ARDS; COVID-19; ICU; intermediate respiratory care unit; lung ultrasound; pneumonia.