LAUSR

INTRODUCTION: Clinical phenotypes of acute hypoxic respiratory failure (AHRF) in COVID-19 have been proposed- Gattinoni type ?L? with less interstitial edema/ lung weight and greater compliance vs type ?H? with a more classic acute respiratory distress syndrome (ARDS) pattern of interstitial edema, higher lung weight and lower compliance Lung ultrasound (LUS) is a sensitive tool for the detection of interstitial pulmonary edema Our objective was to describe lung US profiles in COVID-19 induced AHRF, in association with markers of severity and outcomes METHODS: Retrospective observational study Consecutive critically-ill adult COVID-19 patients with AHRF and P/F ratio 1cm thickness) B and C profiles could overlap The A-profile was compared to all others in the analyses of statistical significance Outcomes included the need for and duration of mechanical ventilation, need for tracheostomy and mortality RESULTS: Ten patients met eligibility criteria 3 demonstrated A-profile, 6 B-profile and 1 C-profile Median days (interquartile range) from symptom onset to LUS was: A- 6 (6-14, p=0 20), B- 18 (8-30), C- 6 Median P/F ratio at the time of LUS was: A- 152 (103-269, p=0 31), B- 131 (112- 146), C-98 Median C-reactive protein (mg/dL): A- 8 (5-10, p=0 3), B- 18 (6-31), C- 12 Median Lactate Dehydrogenase (IU/L) was: A- 528 (287-594, p=0 36), B- 622 (528-787), C- 258 Median D-Dimer (mg/L FEU) was: A- 0 88 (0 64- 3 12, p=0 57), B- 2 50 (1 74-35 00), C- 0 35 Mechanical ventilation was required in: A- 1 (33%, p=0 067), 6 (100%), C- 1 (100%) Median days of mechanical ventilation was: A- 0 (0-20, p=0 03), B- 36 (32-52), C- 88 Median static compliance (mL/cmH2O) was: A- 18, B- 27 (25-28), C- 37 Tracheostomy was performed in: A- 0 (0%, p=0 008), B- 6 (100%), C- 1 (100%) Mortality was: A- 0, B- 1 (17%), C- 0 CONCLUSIONS: An A-profile on LUS appeared to be associated with less severe respiratory illness in COVID-19 AHRF with P/F< 300mmHg