Abstract
Chest computed tomography (CT) may provide insights into the pathophysiology of coronavirus disease 2019 (COVID-19), although it is not suitable for a timely bedside dynamic assessment of patients admitted to intensive care unit (ICU); therefore, lung ultrasound (LUS) has been proposed as a complementary diagnostic tool. The aims of this study were to investigate different lungs phenotypes in patients with COVID-19 and to assess the differences in CT and LUS scores between ICU survivors and non-survivors. We also explored the association between CT and LUS, and oxygenation (arterial partial pressure of oxygen [PaO 2 ]/fraction of inspired oxygen [FiO 2] ) and clinical parameters. The study included 39 patients with COVID-19. CT scans revealed types 1, 2 and 3 phenotypes in 62%, 28% and 10% of patients, respectively. Among survivors, pattern 1 was prevalent (p < 0.005). Chest CT and LUS scores differed between survivors and non-survivors both at ICU admission and 10 days after and were associated with ICU mortality. Chest CT score was positively correlated with LUS findings at ICU admission (r = 0.953, p < 0.0001) and was inversely correlated with PaO 2 /FiO 2 (r = -0.375, p = 0.019) and C-reactive protein (r = 0.329, p = 0.041). LUS score was inversely correlated with PaO 2 /FiO 2 (r = -0.345, p = 0.031). COVID-19 presents distinct phenotypes with differences between survivors and non-survivors. LUS is a valuable monitoring tool in an ICU setting because it may correlate with CT findings and mortality, although it cannot predict oxygenation changes.
Keywords: COVID-19; CT scan; ICU; LUS; Lung ultrasound; Phenotypes; SARS-CoV-2.
【저자키워드】 COVID-19, SARS-CoV-2., ICU, Lung ultrasound, CT scan, LUS, Phenotypes, 【초록키워드】 coronavirus disease, SARS-CoV-2, Mortality, intensive care, diagnostic, lung, C-reactive protein, oxygen, Computed tomography, Survivors, pathophysiology, Patient, ICU admission, phenotype, parameters, patients, predict, association, complementary, Oxygenation, changes, Non-survivors, survivor, non-survivor, prevalent, correlated, CT finding, PaO, patients with COVID-19, positively correlated, 【제목키워드】 Ultrasound, clinical, Ill,