The prognostic role of lung ultrasound in hospitalized patients with COVID-19

The use of lung ultrasound (LUS) has recently become vital in the diagnosis and prognosis of various respiratory diseases. Its role in COVID-19 requires further investigation. <bold>Aim:</bold> to evaluate the prognostic role of LUS in hospitalized COVID-19 patients assessing correlations with chest CT and clinical markers of severity. Twenty-five consecutive, non-ICU hospitalised COVID-19 patients, from June to December 2021 were included. LUS was performed on admission and sequentially every 3 days at 8 points in the chest. Based on the LUS findings (number of B-lines and presence or not of an opacity) a score was designed. Demographic, clinical and laboratory data were recorded. The risk of death from an increase in the score was estimated by applying logarithmic regression models. Its predictive value was estimated by ROC curve analysis. A statistically significant positive correlation was found between the total LUS score at admission and the severity of SARS-COV-2 infection. Higher LUS score at admission was statistically significantly associated with higher PSI and qSOFA index, lower PaO2/FiO2 ratio, use of HFNC, longer hospitalization and greater extent of chest CT infiltrates. For one point of increase in the score, the risk of death increased 1.5-fold (95% CI 0.78 to 2.92). The predictive role of the score in patient outcomes was also very satisfactory (area under the ROC curve= 0.75). Lung ultrasound represents a critical tool for assessing the severity and prognosis of hospitalized patients with COVID-19. It constitutes a promising and reliable technique for assessing COVID-19 pneumonia, comparable to chest CT, especially in cases where the latter is not feasible.