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?:abstract
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OBJECTIVES: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can generate severe pneumonia associated with high mortality A bedside lung ultrasound (LUS) examination has been shown to have a potential role in this setting The purpose of this study was to evaluate the potential prognostic value of a new LUS protocol (evaluation of 14 anatomic landmarks, with graded scores of 0-3) in patients with SARS-CoV-2 pneumonia and the association of LUS patterns with clinical or laboratory findings METHODS: A cohort of 52 consecutive patients with laboratory-confirmed SARS-CoV-2 underwent LUS examinations on admission in an internal medicine ward and before their discharge A total LUS score as the sum of the scores at each explored area was computed We investigated the association between the LUS score and clinical worsening, defined as a combination of high-flow oxygen support, intensive care unit admission, or 30-day mortality as the primary end point RESULTS: Twenty (39%) patients showed a worse outcome during the observation period;the mean LUS scores ± SDs were 20 4 ± 8 5 and 29 2 ± 7 3 in patients without and with worsening, respectively (P 2), age (>65 years), sex (male), and body mass index (≥25 kg/m(2) ), the association between the LUS score and worsening (odds ratio, 1 17;95% confidence interval, 1 05 to 1 29;P = 003) was confirmed, with good discrimination of the model (area under the receiver operating characteristic curve, 0 82) A median LUS score higher than 24 was associated with an almost 6-fold increase in the odds of worsening (odds ratio, 5 67;95% confidence interval, 1 29 to 24 8;P = 021) CONCLUSIONS: Lung ultrasound can represent an effective tool for monitoring and stratifying the prognosis of patients with SARS-CoV-2 pulmonary involvement
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