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. 2021 Apr 9;13(1):19.
doi: 10.1186/s13089-021-00223-9.

One-month outcomes of patients with SARS-CoV-2 infection and their relationships with lung ultrasound signs

Thiago Thomaz Mafort  1   2 , Rogério Rufino  1   2 , Claudia Henrique da Costa  1   2 , Mariana Soares da Cal  1 , Laura Braga Monnerat  1 , Patrícia Frascari Litrento  1 , Laura Lizeth Zuluaga Parra  1 , Arthur de Sá Earp de Souza Marinho  1 , Agnaldo José Lopes  3   4   5
Affiliations

One-month outcomes of patients with SARS-CoV-2 infection and their relationships with lung ultrasound signs

Thiago Thomaz Mafort et al. Ultrasound J. .

Abstract

Background: The role of lung ultrasound (LUS) in evaluating the mid- and long-term prognoses of patients with COVID-19 pneumonia is not yet known. The objectives of this study were to evaluate associations between LUS signs at the time of screening and clinical outcomes 1 month after LUS and to assess LUS signs at the time of presentation with known risk factors for COVID-19 pneumonia.

Methods: This was a retrospective study of data prospectively collected 1 month after LUS screening of 447 adult patients diagnosed with COVID-19 pneumonia. Sonographic examination was performed in screening tents with the participants seated. The LUS signs (B-lines > 2, coalescent B-lines, and subpleural consolidations) were captured in six areas of each hemithorax and a LUS aeration score was calculated; in addition, the categories of disease probability based on patterns of LUS findings (high-probability, intermediate-probability, alternate, and low-probability patterns) were evaluated. The LUS signs at patients' initial evaluation were related to the following outcomes: symptomatology, the need for hospitalization or invasive mechanical ventilation (IMV), and COVID-19-related death.

Results: According to the evaluations performed 1 month after LUS screening, 36 patients were hospitalised, eight of whom required intensive care unit (ICU) admission and three of whom died. The presence of coalescent B-lines was associated with the need for hospitalization (p = 0.008). The presence of subpleural consolidations was associated with dyspnoea (p < 0.0001), cough (p = 0.003), the need for hospitalization (p < 0.0001), the need for ICU admission (p < 0.0001), and death (p = 0.002). A higher aeration score was associated with dyspnoea (p < 0.0001), the need for hospitalization (p < 0.0001), the need for ICU admission (p < 0.0001), and death (p = 0.003). In addition, patients with a high-probability LUS pattern had a higher aeration score (p < 0.0001) and more dyspnoea (p = 0.024) and more often required hospitalization (p < 0.0001) and ICU admission (p = 0.031).

Conclusions: In patients with COVID-19 pneumonia, LUS signs were related to respiratory symptoms 1 month after LUS screening. Strong relationships were identified between LUS signs and the need for hospitalization and death.

Keywords: 1-month outcomes; COVID-19; Lung ultrasound; Pneumonia; SARS-CoV-2.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Fig. 1
Fig. 1
Representation of the 12 zones on the chest. a The anterior and axillary zones; b the posterior zones. The zones 1 and 2 are limited by the parasternal and anterior axillary lines. The zones 3 and 4 are limited by the anterior axillary and posterior axillary lines. Finally, the zones 5 and 6 are limited by the paravertebral and posterior axillary lines and by the contour of the scapula
Fig. 2
Fig. 2
Relationships between the presence of subpleural consolidation on lung ultrasound and the outcomes of a hospitalization (p < 0.0001) and b death (p = 0.002)
Fig. 3
Fig. 3
Relationships between the aeration score on lung ultrasound and the outcomes of a hospitalization (p < 0.0001) and b death (p = 0.003)
See this image and copyright information in PMC

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