Lung Ultrasound Integration in Assessment of Patients with Noncritical COVID‐19

Gil‐Rodrigo, Adriana; Llorens, Pere; Luque‐Hernández, María‐José; Martínez‐Buendía, Carmen; Ramos‐Rincón, José‐Manuel

OBJECTIVES: Performing lung ultrasound during the clinical assessment of patients with suspicion of noncritical COVID‐19 may increase the diagnostic rate of pulmonary involvement over other diagnostic techniques used in routine clinical practice. This study aims to compare complications (readmissions, emergency department [ED] visits, and length of outpatient follow‐up) in the first 30 days after ED discharge in patients with confirmed COVID‐19 who were managed with versus without lung ultrasound. MATERIALS AND METHODS: Prospective, observational, analytical study in noncritical patients with confirmed respiratory disease due to SARS‐CoV‐2, assessed in the ED of a tertiary Spanish hospital in March and April 2020. We compared 2 cohorts, differentiated by the use of lung ultrasound as a diagnostic tool. Complications were assessed (hospital admissions, ED revisits and days of outpatient follow‐up) at 30 days postdischarge. RESULTS: Of the 88 included patients, 31% (n = 27) underwent an initial lung ultrasound, while 61 (68%) did not. In 82.5% of the patients evaluated with ultrasound, the most predominant areas affected were the posterobasal regions, in the form of focalized and confluent B‐lines; 70.4% showed pleural irregularity in these same areas. Use of the lung ultrasound was associated with a greater probability of hospital admission (odds ratio 5.63, 95% confidence interval 3.31 to 9.57; p < 0.001). However, it was not significantly associated with mortality or short‐term complications. CONCLUSIONS: Lung ultrasound could identify noncritical patients with lung impairment due to SARS‐CoV‐2, in whom other tests used routinely show no abnormalities. However, it has not shown a prognostic value in these patients and could generate a higher percentage of hospital admissions. More studies are still needed to demonstrate the clear benefit of this use.