Lung Ultrasound Findings Are Associated with Mortality and Need for Intensive Care Admission in COVID-19 Patients Evaluated in the Emergency Department

Nicola Bonadia, Annamaria Carnicelli, Alfonso Piano, Danilo Buonsenso, Emanuele Gilardi, Cristina Kadhim, Enrico Torelli, Martina Petrucci, Luca Di Maurizio, Daniele Guerino Biasucci, Mariella Fuorlo, Evelina Forte, Raffaella Zaccaria, Francesco Franceschi

Research output: Contribution to journalArticlepeer-review

Abstract

Lung ultrasound (LUS) has recently been advocated as an accurate tool to diagnose coronavirus disease 2019 (COVID-19) pneumonia. However, reports on its use are based mainly on hypothesis studies, case reports or small retrospective case series, while the prognostic role of LUS in COVID-19 patients has not yet been established. We conducted a prospective study aimed at assessing the ability of LUS to predict mortality and intensive care unit admission of COVID-19 patients evaluated in a tertiary level emergency department. Patients in our sample had a median of 6 lung areas with pathologic findings (inter-quartile range [IQR]: 6, range: 0–14), defined as a score different from 0. The median rate of lung areas involved was 71% (IQR: 64%, range: 0–100), while the median average score was 1.14 (IQR: 0.93, range: 0–3). A higher rate of pathologic lung areas and a higher average score were significantly associated with death, with an estimated difference of 40.5% (95% confidence interval [CI]: 4%–68%, p = 0.01) and of 0.47 (95% CI: 0.06–0.93, p = 0.02), respectively. Similarly, the same parameters were associated with a significantly higher risk of intensive care unit admission with estimated differences of 29% (95% CI: 8%–50%, p = 0.008) and 0.47 (95% CI: 0.05–0.93, p = 0.02), respectively. Our study indicates that LUS is able to detect COVID-19 pneumonia and to predict, during the first evaluation in the emergency department, patients at risk for intensive care unit admission and death.

Original languageEnglish
Pages (from-to)2927-2937
Number of pages11
JournalUltrasound in Medicine and Biology
Volume46
Issue number11
DOIs
Publication statusPublished - Nov 2020

Keywords

  • COVID-19
  • Emergency medicine
  • Lung ultrasound
  • Pneumonia
  • SARS-CoV-2

ASJC Scopus subject areas

  • Biophysics
  • Radiological and Ultrasound Technology
  • Acoustics and Ultrasonics

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