RT Journal Article
SR Electronic
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
FD European Respiratory Society
SP 00128-2022
DO 10.1183/23120541.00128-2022
VO 8
IS 4
A1 Søren Helbo Skaarup
A1 Rasmus Aagaard
A1 Stig Holm Ovesen
A1 Jesper Weile
A1 Hans Kirkegaard
A1 Caroline Espersen
A1 Mats Christian Højbjerg Lassen
A1 Kristoffer Grundtvig Skaarup
A1 Stefan Posth
A1 Christian B. Laursen
A1 Ask Bock
A1 Michael Dan Arvig
A1 Tor Biering-Sørensen
YR 2022
UL http://openres.ersjournals.com/content/8/4/00128-2022.abstract
AB Background In this study we aimed to assess if a focused lung ultrasound examination predicts the need for mechanical ventilation, admission to an intensive care unit, high-flow oxygen treatment, death from 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 multicentre 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 (relative risk 2.44, 95% CI 1.32–5.52), admission to intensive care (relative risk 2.55, 95% CI 1.41–54.59) and high-flow oxygen treatment (relative risk 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 area under the receiver operating characteristic curve 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 the need for high-flow oxygen treatment. Thus, focused lung ultrasound may be used to risk stratify patients with COVID-19 symptoms.Focused lung ultrasound can predict need for intensive care treatment in patients with confirmed or suspected COVID-19. A simple ultrasound examination including only the anterior and lateral sides of the thorax is accurate. https://bit.ly/3CTf3p6