In:
Respiration, S. Karger AG, Vol. 101, No. 2 ( 2022), p. 122-131
Kurzfassung:
〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Point-of-care lung ultrasound (LUS) score is a semiquantitative score of lung damage severity. High-resolution computed tomography (HRCT) is the gold standard method to evaluate the severity of lung involvement from the novel coronavirus disease (COVID-19). Few studies have investigated the clinical significance of LUS and HRCT scores in patients with COVID-19. Therefore, the aim of this study was to evaluate the prognostic yield of LUS and of HRCT in COVID-19 patients. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We carried out a multicenter, retrospective study aimed at evaluating the prognostic yield of LUS and HRCT by exploring the survival curve of COVID-19 inpatients. LUS and chest CT scores were calculated retrospectively by 2 radiologists with & #x3e;10 years of experience in chest imaging, and the decisions were reached in consensus. LUS score was calculated on the basis of the presence or not of pleural line abnormalities, B-lines, and lung consolidations. The total score (range 0–36) was obtained from the sum of the highest scores obtained in each region. CT score was calculated for each of the 5 lobes considering the anatomical extension according to the percentage parenchymal involvement. The resulting overall global semiquantitative CT score was the sum of each single lobar score and ranged from 0 (no involvement) to 25 (maximum involvement). 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 One hundred fifty-three COVID-19 inpatients (mean age 65 ± 15 years; 65% M), including 23 (15%) in-hospital deaths for any cause over a mean follow-up of 14 days were included. Mean LUS and CT scores were 19 ± 12 and 10 ± 7, respectively. A strong positive linear correlation between LUS and CT scores (Pearson correlation 〈 i 〉 r 〈 /i 〉 = 0.754; 〈 i 〉 R 〈 /i 〉 〈 sup 〉 2 〈 /sup 〉 = 0.568; 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001) was observed. By ROC curve analysis, the optimal cut-point for mortality prediction was 20 for LUS score and 4.5 for chest CT score. According to Kaplan-Meier survival analysis, in-hospital mortality significantly increased among COVID-19 patients presenting with an LUS score ≥20 (log-rank 0.003; HR 9.87, 95% CI: 2.22–43.83) or a chest CT score ≥4.5 (HR 4.34, 95% CI: 0.97–19.41). At multivariate Cox regression analysis, LUS score was the sole independent predictor of in-hospital mortality yielding an adjusted HR of 7.42 (95% CI: 1.59–34.5). 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 LUS score is useful to stratify the risk in COVID-19 patients, predicting those that are at high risk of mortality.
Materialart:
Online-Ressource
ISSN:
0025-7931
,
1423-0356
Sprache:
Englisch
Verlag:
S. Karger AG
Publikationsdatum:
2022
ZDB Id:
1464419-8
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