Respiratory Department, Institut d'Investigació Biomèdica de Bellvitge, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain.
Universitat de Barcelona, Campus Bellvitge, L'Hospitalet de Llobregat, Spain.
Respir Care. 2021 Aug;66(8):1263-1270. doi: 10.4187/respcare.08648. Epub 2021 May 18.
Patients with coronavirus disease 2019 (COVID-19) can develop severe bilateral pneumonia leading to respiratory failure. We aimed to study the potential role of lung ultrasound score (LUS) in subjects with COVID-19.
We conducted an observational, prospective pilot study, including consecutive subjects admitted to an intermediate care unit due to COVID-19 pneumonia. LUS is a 12-zone examination method for lung parenchyma assessment. LUS was performed with a portable convex transducer, scores from 0 to 36 point. Clinical and demographic data were collected at LUS evaluation. Survival analysis was performed using a composite outcome including ICU admission or death. Subjects were followed for 30 d from LUS assessment.
Of 36 subjects included, 69.4% were male, and mean age was 60.19 ± 12.75 y. A cutoff LUS ≥ 24 points showed 100% sensitivity, 69.2% specificity, and an area under the receiver operating characteristic curve of 0.85 for predicting worse prognosis. The composite outcome was present in 10 subjects (55.6%) with LUS ≥ 24 points, but not in the group with lower LUS scores ( < .001). Subjects with LUS ≥ 24 points had a higher risk of ICU admission or death (hazard ratio 9.97 [95% CI 2.75-36.14], < .001). Significant correlations were observed between LUS and [Formula: see text], serum D-dimer, C-reactive protein, lactate dehydrogenase, and lymphocyte count.
LUS ≥ 24 points can help identify patients with COVID-19 who are likely to require ICU admission or to die during follow-up. LUS also correlates significantly with clinical and laboratory markers of COVID-19 severity.
2019 年冠状病毒病（COVID-19）患者可发展为严重双侧肺炎，导致呼吸衰竭。我们旨在研究肺部超声评分（LUS）在 COVID-19 患者中的潜在作用。
我们进行了一项观察性、前瞻性试点研究，纳入了因 COVID-19 肺炎而入住中级护理病房的连续患者。LUS 是一种用于评估肺实质的 12 区检查方法。使用便携式凸阵换能器进行 LUS，评分范围为 0 至 36 分。在 LUS 评估时收集临床和人口统计学数据。使用包括 ICU 入院或死亡在内的复合结局进行生存分析。从 LUS 评估开始对患者进行 30 天随访。
36 例患者中，69.4%为男性，平均年龄为 60.19±12.75 岁。LUS≥24 分的截点对预测不良预后具有 100%的敏感性、69.2%的特异性和 0.85 的受试者工作特征曲线下面积。LUS≥24 分的 10 例患者（55.6%）出现复合结局，但 LUS 评分较低的患者中未出现（<0.001）。LUS≥24 分的患者 ICU 入院或死亡风险更高（风险比 9.97[95%CI 2.75-36.14]，<0.001）。LUS 与[Formula: see text]、血清 D-二聚体、C 反应蛋白、乳酸脱氢酶和淋巴细胞计数之间存在显著相关性。
LUS≥24 分可帮助识别可能需要 ICU 入院或在随访期间死亡的 COVID-19 患者。LUS 还与 COVID-19 严重程度的临床和实验室标志物显著相关。
