RT Journal Article
SR Electronic
T1 Lung Ultrasound Findings Associated With COVID-19 ARDS, ICU Admission, and All-Cause Mortality
JF Respiratory Care
FD American Association for Respiratory Care
SP respcare.09108
DO 10.4187/respcare.09108
A1 Caroline Espersen
A1 Elke Platz
A1 Kristoffer Grundtvig Skaarup
A1 Mats Christian Højbjerg Lassen
A1 Jannie Nørgaard Lind
A1 Niklas Dyrby Johansen
A1 Morten Sengeløv
A1 Alia Saed Alhakak
A1 Anne Bjerg Nielsen
A1 Henning Bundgaard
A1 Christian Hassager
A1 Reza Jabbari
A1 Jørn Carlsen
A1 Ole Kirk
A1 Matias Greve Lindholm
A1 Ole Peter Kristiansen
A1 Olav Wendelboe Nielsen
A1 Klaus Nielsen Jeschke
A1 Charlotte Suppli Ulrik
A1 Pradeesh Sivapalan
A1 Gunnar Gislason
A1 Kasper Iversen
A1 Jens Ulrik Stæhr Jensen
A1 Morten Schou
A1 Søren Helbo Skaarup
A1 Tor Biering-Sørensen
YR 2021
UL http://rc.rcjournal.com/content/early/2021/11/23/respcare.09108.abstract
AB 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).