PROGNOSTIC VALUE OF LUNG ULTRASOUND IN OLDER NURSING HOME RESIDENTS AFFECTED BY COVID-19

Veronese, Nicola; Sbrogiò, Luca Gino; Valle, Roberto; Marin, Laura; Fiore, Elena Boscolo; Tiozzo, Andrea

ABSTRACT Objectives Lung ultrasound (LUS) imaging may play an important role in the management of patients with COVID-19–associated lung injury, particularly in some special populations. However data regarding the prognostic role of the LUS in nursing home residents, one of the most affected populations by COVID-19, are not still available. Design Retrospective. Settings and participants Nursing home residents, affected by COVID-19, were followed-up with a LUS from 08th April to 14th May 2020 in Chioggia, Venice. Methods COVID-19 was diagnosed through a nasopharyngeal swab. LUS results were scored using a 12-zone method. For each of the 12 zones (two posterior, two anterior, two lateral), the possible score ranged from 0 to 3 (1= presence of B lines separated, < 50% of space from the pleural line; 2= presence of B lines separated, > 50% of space from the pleural line; 3= lung thickening with tissue-like aspect). The total score ranged from 0 to 36. Mortality was assessed using administrative data. Data regarding accuracy (and related parameters) were reported. Results Over 175 nursing home residents, 48 (mean age: 84.1 years; mainly females) were affected by COVID-19. Twelve died during the follow-up period. The mean LUS score was 3. The area under the curve of LUS in predicting mortality was 0.603 (95% confidence intervals: 0.419-0.787) and increase to 0.725 (95% CIs: 0.41-0.99) after including follow-up LUS controls. Taking a LUS score > 4 as exposure variable and mortality as outcome, the sensitivity was 58.33%, specificity 63.89%, a positive likelihood ratio of 1.62 and a negative of 0.65. Conclusions and implications LUS is able to significantly predict mortality in nursing home residents affected by COVID-19, suggesting that this simple tool can be routinely used in this setting instead of more invasive techniques available only in hospital.