Hospital Alemán, Buenos Aires, Argentina.
Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina.
J Bras Pneumol. 2021 Sep 3;47(4):e20210092. doi: 10.36416/1806-3756/e20210092. eCollection 2021.
To evaluate the performance of lung ultrasound to determine short-term outcomes of patients with COVID-19 admitted to the intensive care unit.
This is a Prospective, observational study. Between July and November 2020, 59 patients were included and underwent at least two LUS assessments using LUS score (range 0-42) on day of admission, day 5th, and 10th of admission.
Age was 66.5±15 years, APACHE II was 8.3±3.9, 12 (20%) patients had malignancy, 46 (78%) patients had a non-invasive ventilation/high-flow nasal cannula and 38 (64%) patients required mechanical ventilation. The median stay in ICU was 12 days (IQR 8.5-20.5 days). ICU or hospital mortality was 54%. On admission, the LUS score was 20.8±6.1; on day 5th and day 10th of admission, scores were 27.6±5.5 and 29.4±5.3, respectively (P=0.007). As clinical condition deteriorated the LUS score increased, with a positive correlation of 0.52, P <0.001. Patients with worse LUS on day 5th versus better score had a mortality of 76% versus 33% (OR 6.29, 95%CI 2.01-19.65, p. 0.003); a similar difference was observed on day 10. LUS score of 5th day of admission had an area under the curve of 0.80, best cut-point of 27, sensitivity and specificity of 0.75 and 0.78 respectively.
These findings position LUS as a simple and reproducible method to predict the course of COVID-19 patients.
评估肺部超声在确定入住重症监护病房的 COVID-19 患者短期结局中的性能。
这是一项前瞻性观察性研究。2020 年 7 月至 11 月期间，共纳入 59 例患者，他们在入院当天、第 5 天和第 10 天至少接受了两次肺部超声评估，采用肺部超声评分（范围 0-42）。
年龄为 66.5±15 岁，急性生理学与慢性健康状况评分系统 II（APACHE II）评分为 8.3±3.9，12 例（20%）患者患有恶性肿瘤，46 例（78%）患者接受无创通气/高流量鼻导管通气，38 例（64%）患者需要机械通气。患者 ICU 中位住院时间为 12 天（IQR 8.5-20.5 天）。ICU 或医院死亡率为 54%。入院时肺部超声评分为 20.8±6.1；第 5 天及第 10 天评分分别为 27.6±5.5 和 29.4±5.3（P=0.007）。随着临床病情恶化，肺部超声评分增加，呈正相关（r=0.52，P<0.001）。第 5 天肺部超声评分较差的患者死亡率为 76%，而评分较好的患者死亡率为 33%（OR 6.29，95%CI 2.01-19.65，P<0.001）；第 10 天也观察到了类似的差异。入院第 5 天的肺部超声评分曲线下面积为 0.80，最佳截断值为 27，灵敏度和特异度分别为 0.75 和 0.78。
这些发现表明肺部超声是一种简单且可重复的方法，可预测 COVID-19 患者的病程。
