Lung ultrasound can predict the clinical course and the severity of COVID-19 disease

Ravetti, Cecilia Gómez; Vassallo, Paula Frizera; de Barros, Guilherme Monteiro; Rocha, Guilherme Carvalho; Chamon, Samuel; Borges, Isabela Nascimento; Marinho, Carolina Coimbra; Cabral, Máderson Alvares de Souza; Duani, Helena; de Andrade, Marcus Vinícius Melo; Nobre, Vandack

COVID-19 disease compromises the lung in large numbers of patients. The development of minimally invasive methods to determine the severity of the pulmonary extension is requested. This study aimed to describe the characteristics of sequential lung ultrasound and to test the prognostic usefulness of this exam in a group of patients admitted with COVID-19. We prospectively evaluated patients with SARS-CoV-2 infection admitted to our hospital between April and August 2020. Bedside lung ultrasound (LUS) exams were performed in three-times points: inclusion (D1), after 48 hours (D3), and on the seventh day of follow-up (D7). Lung ultrasound scores were quantified according to the aeration loss in each of 8 zones scanned. Sixty-six patients were included, 42 (63.6%) in the ICU and 24 (36.3%) in the ward. The LUS scores were higher in patients admitted to the ICU than those admitted to the ward on the inclusion (16 [13-17] vs 10 [4-14], p <0.001), after 48h (15.5 [13-17] vs 12.5 [8.2-14.7], p=0.001), and on the seventh day (16 [14-17] vs 7 [4.5 -13.7], p<0.001) respectively. The LUS score measured on the time of inclusion in the study was independently associated with the need for ICU admission (OR=1.480; 95%CI: 1.093-2.004, p=0.011) adjusted by the Sequential Organ Failure Assessment (SOFA) score.