Semiquantitative lung ultrasound scores in the evaluation and follow-up of critically ill patients with COVID-19: a single-center study

Abstract

Rationale and Objectives Chest CT is not suitable for critically ill patients with COVID-19 and lung ultrasound (LUS) may play an important role for these patients. In this study, we summarized the findings of LUS and explore the value of semiquantitative LUS scores in evaluation and follow-up of COVID-19 pneumonia. Materials and Methods Retrospectively studied the LUS and chest CT imaging of 128 critically ill patients with COVID-19. The imaging data were reviewed to acquire the LUS and CT scores. The correlation between LUS scores and CT scores were made to evaluate the accuracy of LUS. A cut-off point of LUS score was calculated to distinguish critical-type patients from severe-type patients. LUS follow-up of 72 patients were compared with the gold standard chest CT. Results The most common LUS features of COVID-19 pneumonia were crowded or coalescent B-lines with multifocal small consolidations in multi-zone. The mean LUS score was 8.1 points in severe-type patients and 15.7 points in critical-type patients (P<0.05). The correlation between LUS scores and CT scores was high (r=0.891, p<0.01) and it was higher in critical-type patients than that in severe-type patients. The LUS score higher than 10.5 points had a 97.4% sensitivity and 75.0% specificity to distinguish critical-type patients. The consistency of LUS and chest CT in follow-up was 0.596, with higher consistency in diagnosis of lesion progression (Kappa values was 0.774). Conclusion Our scoring system provides a more quantitative use of LUS findings and accurate evaluation of lung damage for critically ill patients with COVID-19.

Lung ultrasonography: A prognostic tool in non-ICU hospitalized patients with COVID-19 pneumonia

“…Moreover, the correlation of total LUS score after 72 hours with ICU/death suggests that ultrasonographic monitoring accurately reflects disease progression. This result indicates the potential value of LUS as a tool for dynamic lung monitoring, thus extending what reported by Deng et al and Dargent et al [ 21 , 23 ] to a less critical population.…”

“…To our knowledge this is the first prospective study assessing the potential role of LUS as a prognostic tool in a population of patients admitted to non-ICU units for COVID-19- related pneumonia. Zieleskiewicz et al and Deng et al showed that LUS scores highly correlated with CT scores [ 20 , 21 ]; moreover, the last study showed that the use of a score cut-off was able to distinguish between more and less severe critical patients. Lichter et al showed that LUS score at admission could accurately predict death and need for mechanical ventilation [22] .…”

“…As shown, literature on LUS in COVID-19 patients is rapidly growing; however few studies evaluated the prognostic value of LUS in COVID-19 patients [20] , [21] , [22] , [23] . All these studies enrolled a significant percentage of patients who were hospitalized in Intensive Care Units (ICU).…”

Lung ultrasound score predicts outcomes in COVID-19 patients admitted to the emergency department

“…The lung ultrasound score (LUS) is a semiquantitative score that measures lung aeration loss caused by different pathological conditions [ 18 , 19 ]. There are a few prospective studies demonstrating that lung ultrasound can predict outcomes in COVID-19.…”

Lung Ultrasound Score: A Potential Prediction Tool In Covid-19

“…Lung ultrasound is widely used in Emergency Departments because it is user-friendly, broadly available, low-cost, and has high accuracy for diagnosing pulmonary diseases (17). Recent reports suggests that, in COVID-19 patients, lung ultrasound could be useful in several scenarios: to quantify severity of lung involvement in periodic assessments; to look for ndings suggestive of pneumonia; and to monitor the dynamic effects of mechanical ventilation and recruitment maneuvers on lung aeration (3,18). However, there are no prospective studies demonstrating that lung ultrasound can change management or predict outcomes in COVID-19.…”