Point-of-care lung ultrasound assessment for risk stratification and therapy guiding in COVID-19 patients: a prospective noninterventional study
Open Access
- 11 February 2021
- journal article
- research article
- Published by European Respiratory Society (ERS) in European Respiratory Journal
- Vol. 58 (3), 2004283
- https://doi.org/10.1183/13993003.04283-2020
Abstract
Background Lung ultrasound (LUS) is feasible for assessing lung injury caused by COVID-19. However, the prognostic meaning and time-line changes of lung injury assessed by LUS in COVID-19 hospitalised patients, is unknown. Methods Prospective cohort study designed to analyse prognostic value of LUS in COVID-19 patients by using a quantitative scale (LUZ-score) during the first 72 h after admission. Primary endpoint was in-hospital death and/or admission to the intensive care unit. Total length of hospital stay, increase of oxygen flow or escalate medical treatment during the first 72 h, were secondary endpoints. Results 130 patients were included in the final analysis; mean age was 56.7±13.5 years. Time since the beginning of symptoms until admission was 6 days (4–9). Lung injury assessed by LUZ-score did not differ during the first 72 h (21 points [16–26] at admission versus 20 points [16–27] at 72 h; p=0.183). In univariable logistic regression analysis estimated PaO2/FiO2 (HR 0.99 [0.98–0.99]; p=0.027) and LUZ-score>22 points (5.45 (1.42–20.90); p=0.013) were predictors for the primary endpoint. Conclusions LUZ-score is an easy, simple and fast point of care ultrasound tool to identify patients with severe lung injury due to COVID-19, upon admission. Baseline score is predictive of severity along the whole period of hospitalisation. The score facilitates early implementation or intensification of treatment for COVID-19 infection. LUZ-score may be combined with clinical variables (as estimated PAFI) to further refine risk stratification.Funding Information
- Instituto de investigación Sanitaria de Aragón (COVID-19 2020 crowdfunding campaign)
This publication has 26 references indexed in Scilit:
- Time Course of Lung Changes at Chest CT during Recovery from Coronavirus Disease 2019 (COVID-19)Radiology, 2020
- Clinical and radiological changes of hospitalised patients with COVID-19 pneumonia from disease onset to acute exacerbation: a multicentre paired cohort studyEuropean Radiology, 2020
- Clinical Characteristics of Coronavirus Disease 2019 in ChinaThe New England Journal of Medicine, 2020
- Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, ItalyJama-Journal Of The American Medical Association, 2020
- Clinical features of patients infected with 2019 novel coronavirus in Wuhan, ChinaThe Lancet, 2020
- Ultrasound Guidelines: Emergency, Point-of-Care and Clinical Ultrasound Guidelines in MedicineAnnals of Emergency Medicine, 2017
- Replica a «Valor pronóstico de la medición del diámetro y colapso inspiratorio de la vena cava inferior en la insuficiencia cardiaca aguda»Revista Clínica Española, 2016
- Prognostic value of measuring the diameter and inspiratory collapse of the inferior vena cava in acute heart failureRevista Clínica Española, 2016
- Valor pronóstico de la medición del diámetro y colapso inspiratorio de la vena cava inferior en la insuficiencia cardiaca agudaRevista Clínica Española, 2016
- International evidence-based recommendations for point-of-care lung ultrasoundIntensive Care Medicine, 2012