Background
Lung ultrasound (LUS) scanning is useful to diagnose and assess the severity of pulmonary lesions during COVID-19-related ARDS (CoARDS). A conventional LUS score is proposed to measure the loss of aeration during CoARDS. However, this score was validated during the pre-COVID-19 era in patients with ARDS in the ICU and does not consider the differences with CoARDS. An alternative LUS method is based on grading the percentage of extension of the typical signs of COVID-19 pneumonia on the lung surface (LUSext).
Research Question
Is LUSext feasible in patients with COVID-19 at the onset of disease, and does it correlate with the volumetric measure of severity of COVID-19 pneumonia lesions at CT scan (CTvol)?
Study Design and Methods
This observational study enrolled a convenience sampling of patients in the ED with confirmed COVID-19 whose condition demonstrated pneumonia at bedside LUS and CT scan. LUSext was visually quantified. All CT scan studies were analyzed retrospectively by a specifically designed software to calculate the CTvol. The correlation between LUSext and CTvol, and the correlations of each score with Pao2/Fio2 ratio were calculated.
Results
We analyzed data from 179 patients. Feasibility of LUSext was 100%. Time to perform LUS scan was 5 ± 1.5 mins. LUSext and CTvol were correlated positively (R = 0.67; P < .0001). Both LUSext and CTvol showed negative correlation with Pao2/Fio2 ratio (R = -0.66 and R = -0.54; P < .0001, respectively).
Interpretation
LUSext is a valid measure of the severity of the lesions when compared with the CT scan. Not only are LUSext and CTvol correlated, but they also have similar inverse correlation with the severity of respiratory failure. LUSext is a practical and simple bedside measure of the severity of pneumonia in CoARDS, whose clinical and prognostic impact need to be investigated further.
【저자키워드】 ARDS, COVID-19 pneumonia, interstitial pneumonia, CT volumetry, lung ultrasound scan, lung ultrasound scoring, 【초록키워드】 COVID-19, Respiratory failure, Pneumonia, severity, lung, ICU, severity of COVID-19, CT scan, Patient, prognostic, correlation, patients, diagnose, convenience sampling, onset of disease, lesion, negative correlation, inverse correlation, extension, volumetric, time, Result, enrolled, analyzed, investigated, calculated, demonstrated, correlated, feasible, pulmonary lesion, quantified, calculate, patients with ARDS, patients with COVID-19, pneumonia lesion, 【제목키워드】 COVID-19, protocol, Pneumonia, lung, Lung injury, determine,