LAUSR

Lung ultrasound (LUS) has proven to be useful in the evaluation of lung involvement in COVID-19. However, the effectiveness for predicting the risk of severe disease is still at debate. The aim of the study was to establish the prognostic accuracy of serial LUS examinations in the prediction of clinical deterioration in COVID-19 hospitalized patients.Prospective single-center cohort study of patients hospitalized for COVID-19. The study protocol consisted of a LUS examination within 24 h from admission and a follow-up examination on day 3 of hospitalization. Lung involvement was evaluated by a fourteen-area LUS score. The primary endpoint was the ability of LUS to predict clinical deterioration defined as need for intensive respiratory support with high-flow oxygen or invasive mechanical ventilation.Two hundred patients were included and 35 (17.5%) of them reached the primary endpoint and were transferred to ICU. The LUS score at admission had been significantly higher in the ICU group than in the non-ICU group [22 (IQR 20–26)versus12 (IQR 8–15)]. A LUS score at admission ≥17 showed to be the best cut-off point to discriminate patients with risk of deterioration (AUC 0.95). The absence of progression in LUS score on day 3, significantly increased the prediction accuracy by ruling out deterioration with a negative predictive value of 99.29%.Serial LUS is a reliable tool in predicting the risk of respiratory deterioration in patients hospitalized due to COVID-19 pneumonia. LUS could be further implemented in the future for risk stratification of viral pneumonia.