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Research ArticleOriginal Research

Lung Ultrasound Score to Predict Outcomes in COVID-19

Pere Trias-Sabrià, Maria Molina-Molina, Samantha Aso, Marta Hernández Argudo, Marta Diez-Ferrer, Joan Sabater, Jordi Dorca, Salud Santos and Guillermo Suarez-Cuartin
Respiratory Care August 2021, 66 (8) 1263-1270; DOI: https://doi.org/10.4187/respcare.08648
Pere Trias-Sabrià
Respiratory Department, Institut d’Investigació Biomèdica de Bellvitge, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Spain.
Universitat de Barcelona, Campus Bellvitge, L’Hospitalet de Llobregat, Spain.
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Maria Molina-Molina
Respiratory Department, Institut d’Investigació Biomèdica de Bellvitge, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Spain.
Universitat de Barcelona, Campus Bellvitge, L’Hospitalet de Llobregat, Spain.
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Samantha Aso
Respiratory Department, Institut d’Investigació Biomèdica de Bellvitge, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Spain.
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Marta Hernández Argudo
Respiratory Department, Institut d’Investigació Biomèdica de Bellvitge, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Spain.
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Marta Diez-Ferrer
Respiratory Department, Institut d’Investigació Biomèdica de Bellvitge, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Spain.
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Joan Sabater
Critical Care Department, Institut d’Investigació Biomèdica de Bellvitge, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Spain.
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Jordi Dorca
Respiratory Department, Institut d’Investigació Biomèdica de Bellvitge, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Spain.
Universitat de Barcelona, Campus Bellvitge, L’Hospitalet de Llobregat, Spain.
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Salud Santos
Respiratory Department, Institut d’Investigació Biomèdica de Bellvitge, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Spain.
Universitat de Barcelona, Campus Bellvitge, L’Hospitalet de Llobregat, Spain.
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Guillermo Suarez-Cuartin
Respiratory Department, Institut d’Investigació Biomèdica de Bellvitge, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Spain.
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  • For correspondence: [email protected]
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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 Embedded Image, 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.

  • COVID-19
  • lung ultrasound
  • intermediate respiratory care unit
  • ICU
  • pneumonia
  • ARDS

Footnotes

  • Correspondence: Guillermo Suárez-Cuartín MD PhD, Respiratory Department, Hospital Universitari de Bellvitge, Feixa Llarga S/N 08907 L’Hospitalet de Llobregat, Spain. E-mail: gsuarezc{at}bellvitgehospital.cat
  • Dr Trias-Sabrià presented a version of this paper at the 2020 Annual Congress of the European Respiratory Society, held virtually September 7–9, 2020.

  • The authors have disclosed no conflicts of interest.

  • Copyright © 2021 by Daedalus Enterprises
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Respiratory Care: 66 (8)
Respiratory Care
Vol. 66, Issue 8
1 Aug 2021
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Lung Ultrasound Score to Predict Outcomes in COVID-19
Pere Trias-Sabrià, Maria Molina-Molina, Samantha Aso, Marta Hernández Argudo, Marta Diez-Ferrer, Joan Sabater, Jordi Dorca, Salud Santos, Guillermo Suarez-Cuartin
Respiratory Care Aug 2021, 66 (8) 1263-1270; DOI: 10.4187/respcare.08648

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Lung Ultrasound Score to Predict Outcomes in COVID-19
Pere Trias-Sabrià, Maria Molina-Molina, Samantha Aso, Marta Hernández Argudo, Marta Diez-Ferrer, Joan Sabater, Jordi Dorca, Salud Santos, Guillermo Suarez-Cuartin
Respiratory Care Aug 2021, 66 (8) 1263-1270; DOI: 10.4187/respcare.08648
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Keywords

  • COVID-19
  • lung ultrasound
  • intermediate respiratory care unit
  • ICU
  • pneumonia
  • ARDS

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