%0 Journal Article %A Caroline Espersen %A Elke Platz %A Kristoffer Grundtvig Skaarup %A Mats Christian Højbjerg Lassen %A Jannie Nørgaard Lind %A Niklas Dyrby Johansen %A Morten Sengeløv %A Alia Saed Alhakak %A Anne Bjerg Nielsen %A Henning Bundgaard %A Christian Hassager %A Reza Jabbari %A Jørn Carlsen %A Ole Kirk %A Matias Greve Lindholm %A Ole Peter Kristiansen %A Olav Wendelboe Nielsen %A Klaus Nielsen Jeschke %A Charlotte Suppli Ulrik %A Pradeesh Sivapalan %A Gunnar Gislason %A Kasper Iversen %A Jens Ulrik Stæhr Jensen %A Morten Schou %A Søren Helbo Skaarup %A Tor Biering-Sørensen %T Lung Ultrasound Findings Associated With COVID-19 ARDS, ICU Admission, and All-Cause Mortality %D 2021 %R 10.4187/respcare.09108 %J Respiratory Care %P respcare.09108 %X BACKGROUND: As lung ultrasound (LUS) has emerged as a diagnostic tool in patients with COVID-19, we sought to investigate the association between LUS findings and the composite in-hospital outcome of ARDS incidence, ICU admission, and all-cause mortality.METHODS: In this prospective, multi-center, observational study, adults with laboratory-confirmed SARS-CoV-2 infection were enrolled from non-ICU in-patient units. Subjects underwent an LUS evaluating a total of 8 zones. Images were analyzed off-line, blinded to clinical variables and outcomes. A LUS score was developed to integrate LUS findings: ≥ 3 B-lines corresponded to a score of 1, confluent B-lines to a score of 2, and subpleural or lobar consolidation to a score of 3. The total LUS score ranged from 0–24 per subject.RESULTS: Among 215 enrolled subjects, 168 with LUS data and no current signs of ARDS or ICU admission (mean age 59 y, 56% male) were included. One hundred thirty-six (81%) subjects had pathologic LUS findings in ≥ 1 zone (≥ 3 B-lines, confluent B-lines, or consolidations). Markers of disease severity at baseline were higher in subjects with the composite outcome (n = 31, 18%), including higher median C-reactive protein (90 mg/L vs 55, P < .001) and procalcitonin levels (0.35 μg/L vs 0.13, P = .033) and higher supplemental oxygen requirements (median 4 L/min vs 2, P = .001). However, LUS findings and score did not differ significantly between subjects with the composite outcome and those without, and were not associated with outcomes in unadjusted and adjusted logistic regression analyses.CONCLUSIONS: Pathologic findings on LUS were common a median of 3 d after admission in this cohort of non-ICU hospitalized subjects with COVID-19 and did not differ among subjects who experienced the composite outcome of incident ARDS, ICU admission, and all-cause mortality compared to subjects who did not. These findings should be confirmed in future investigations. The study is registered at Clinicaltrials.gov (NCT04377035). %U https://rc.rcjournal.com/content/respcare/early/2021/11/23/respcare.09108.full.pdf