Abstract
Background In this study we aimed to assess if a focused lung ultrasound examination predict the need for mechanical ventilation admission to an intensive care unit, high-flow oxygen treatment, death of COVID-19 within 30 days and 30-day all-cause mortality in patients with clinical suspicion of COVID-19 or PCR-verified SARS-CoV-2 infection.
Methods A multicenter prospective cohort trial was performed. Film clips from focused lung ultrasound examinations were recorded and rated by blinded observers using different scoring systems. A prediction model was built and used to test relationship between lung ultrasound scores and clinical outcomes. Diagnostic performance of scoring systems was analysed.
Results A total of 3889 film clips of 398 patients were analysed. Patients who had any of the outcomes of interest had a significantly higher ultrasound score than those who did not. Multivariable logistic regression analyses showed that lung ultrasound predicts mechanical ventilation (RR 2.44, 95% CI 1.32–5.52), admission to intensive care (RR 2.55, 95% CI 1.41–54.59) and high-flow oxygen treatment (RR 1.95, 95% CI 1.5–2.53) but not survival when adjusting for sex, age and relevant comorbidity. There was no diagnostic difference in AUC-ROC between a scoring system using only anterolateral thorax zones and a scoring system that also included dorsal zones.
Conclusion Focused lung ultrasound in patients with clinical suspicion of COVID-19 predicts respiratory failure requiring mechanical ventilation, admission to intensive care units and high-flow oxygen. Thus, focused lung ultrasound may be used to risk stratify patients with COVID-19 symptoms.
Footnotes
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- Received March 13, 2022.
- Accepted August 22, 2022.
- Copyright ©The authors 2022
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