Lung Ultrasound Score in Evaluating The Severity Of Coronavirus Disease 2019 (COVID-19) Pneumonia

Zhao, Lina; Yu, Kanglong; Zhao, Qi; Tian, Rui; Xie, Hui; Xie, Lijun; Deng, Puyu; Xie, Guogang; Bao, Aihua; Yu, Kanglong; Du, Jiang

The purpose of this study is to observe the potential of lung ultrasound in evaluating the severity of COVID-19 pneumonia. Lung ultrasound of patients was performed in ten zones of the chest walls. The features of the ultrasound images were observed, and a lung ultrasound score (LUS) was recorded. The ultrasound features and scores were compared between the refractory group (PaO2/FiO2≤100 mmHG or on ECMO) and the nonrefractory group. The prediction value of the LUS was studied by receiver operating characteristic (ROC) curve analysis. In total, 7 patients were enrolled in the refractory group and 28 in the nonrefractory group. B-line patterns and shred signs were the most common signs in all patients. Patients in the refractory group had significantly more ground-glass signs (median 6 [interquartile range (IQR), 2.5-6.5] vs median 0 [IQR, 0-3]), consolidation signs (median 1 [IQR, 1-1.5] vs median 0 [IQR, 0-3]) and pleural effusions (median 5 [IQR, 1.5-6] vs median 0 [IQR, 0-0.25]). The LUS was significantly higher in the refractory group (33.00 [IQR 27.50, 34.00] vs 25.50 [IQR 22.75, 30.00]). The ROC of the LUS showed a cutoff score of 32 with a specificity of 0.893 and a sensitivity of 0.571 in diagnosing refractory respiratory failure among patients. In COVID-19 patients, lung ultrasound is a promising diagnostic tool in diagnosing patients with refractory pneumonia.