TY - JOUR T1 - Focused lung ultrasound to predict respiratory failure in patients with symptoms of COVID-19. A multicentre prospective cohort study JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00128-2022 SP - 00128-2022 AU - Søren Helbo Skaarup AU - Rasmus Aagaard AU - Stig Holm Ovesen AU - Jesper Weile AU - Hans Kirkegaard AU - Caroline Espersen AU - Mats Christian Højbjerg Lassen AU - Kristoffer Grundtvig Skaarup AU - Stefan Posth AU - Christian B. Laursen AU - Ask Bock AU - Michael Dan Arvig AU - Tor Biering-Sørensen Y1 - 2022/01/01 UR - http://openres.ersjournals.com/content/early/2022/08/24/23120541.00128-2022.abstract N2 - 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.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: None of the authors have any conflicts of interest to report. ER -