https://doi.org/10.4081/ecj.2024.12268
Prognostic value of lung ultrasound score performed in the Emergency Department in COVID-19 patients: a prospective multicenter study in central Italy
Submitted: 9 January 2024
Accepted: 13 February 2024
Published: 4 March 2024
Accepted: 13 February 2024
Abstract Views: 1498
PDF: 403
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Lung ultrasound (LUS) is an essential tool for respiratory disease differential diagnosis at Emergency Department (ED), due to easy applicability and safety. During Sars-Cov 2 pandemic, LUS was widely used in every setting. This study aims to demonstrate the prognostic role of LUS independently of other factors and the identification of an LUS score cut-off to be applied in the ED. A multi-center prospective study was conducted on 285 patients, 123 from Pisa University Hospital, 162 from S. Maria Misericordia Hospital of Perugia. All patients received LUS examination by expert sonographers within 48 hours of admission with the same methodology. Univariate logistic analysis demonstrated that LUS is a mortality predictor, OR 2.8 (CL1.5-5.1). Using LUS score cut-off 1.3, the OR was 6.7 (CL2.7-1.6). In multivariate logistic analysis, LUS score significantly predicted death, independently of other factors. ROC curves comparison demonstrated that the introduction of LUS score <1.3 to a multifactorial model improved the association with mortality (AUC 0.76vs0.84, p=0.04). LUS combined with clinical, anamnestic, laboratory, and blood gas parameters, would allow an effective prognostic stratification in Sars-Cov2 patients at ED.
Li Y, Xia L. Coronavirus Disease 2019 (COVID-19): Role of Chest CT in Diagnosis and Management. AJR Am J Roentgenol 2020;214:1280-6.
DOI: https://doi.org/10.2214/AJR.20.22954
Islam N, Ebrahimzadeh S, Salameh JP, et al. Thoracic imaging tests for the diagnosis of COVID-19. Cochrane Database Syst Rev 2021;3:CD013639.
Xu Z, Shi L, Wang Y, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med 2020;8:420-2.
DOI: https://doi.org/10.1016/S2213-2600(20)30076-X
Bellone A, Etteri M, Maino C, et al. The role of bedside ultrasound in the diagnosis and outcome of patients with acute respiratory failure. Emerg Care J 2013;9:e2.
DOI: https://doi.org/10.4081/ecj.2013.e2
Volpicelli G, Gargani L, Perlini S, et al. Lung ultrasound for the early diagnosis of COVID-19 pneumonia: an international multicenter study. Intensive Care Med 2021;47:444-54.
DOI: https://doi.org/10.1007/s00134-021-06373-7
Volpicelli G, Gargani L. Sonographic signs and patterns of COVID-19 pneumonia. Ultrasound J 2020;12:22.
DOI: https://doi.org/10.1186/s13089-020-00171-w
Vetrugno L, Bove T, Orso D, et al. Lung Ultrasound and the COVID-19 "Pattern": Not All That Glitters Today Is Gold Tomorrow. J Ultrasound Med 2020;39:2281-2.
DOI: https://doi.org/10.1002/jum.15327
Gargani L, Soliman-Aboumarie H, Volpicelli G, et al. Why, when, and how to use lung ultrasound during the COVID-19 pandemic: enthusiasm and caution. Eur Heart J Cardiovasc Imaging 2020;21:941-8.
DOI: https://doi.org/10.1093/ehjci/jeaa163
Vetrugno L, Bove T, Orso D, et al. Our Italian experience using lung ultrasound for identification, grading and serial follow-up of severity of lung involvement for management of patients with COVID-19. Echocardiography 2020;37:625-7.
DOI: https://doi.org/10.1111/echo.14664
Barbieri G, Gargani L, Lepri V, et al. Long-term lung ultrasound follow-up in patients after COVID-19 pneumonia hospitalization: A prospective comparative study with chest computed tomography. Eur J Intern Med 2023;110:29-34.
DOI: https://doi.org/10.1016/j.ejim.2022.12.002
Zheng Z, Peng F, Xu B, et al. Risk factors of critical & mortal COVID-19 cases: A systematic literature review and meta-analysis. J Infect 2020;81:e16-e25.
DOI: https://doi.org/10.1016/j.jinf.2020.04.021
Grasselli G, Greco M, Zanella A, et al. Risk Factors Associated With Mortality Among Patients With COVID-19 in Intensive Care Units in Lombardy, Italy. JAMA Intern Med 2020;180:1345-55.
DOI: https://doi.org/10.1001/jamainternmed.2020.3539
Wynants L, Van Calster B, Collins GS, et al. Prediction models for diagnosis and prognosis of covid-19: systematic review and critical appraisal. BMJ 2020;369:m1328.
DOI: https://doi.org/10.1136/bmj.m1328
Chu K, Alharahsheh B, Garg N, Guha P. Evaluating risk stratification scoring systems to predict mortality in patients with COVID-19. BMJ Health Care Inform 2021;28:e100389.
DOI: https://doi.org/10.1136/bmjhci-2021-100389
Bima P, Pivetta E, Baricocchi D, et al. Lung Ultrasound Improves Outcome Prediction over Clinical Judgment in COVID-19 Patients Evaluated in the Emergency Department. J Clin Med. 2022;11:3032.
DOI: https://doi.org/10.3390/jcm11113032
Lichter Y, Topilsky Y, Taieb P, et al. Lung ultrasound predicts clinical course and outcomes in COVID-19 patients. Intensive Care Med 2020;46:1873-83.
DOI: https://doi.org/10.1007/s00134-020-06212-1
Ravetti CG, Vassallo PF, de Barros GM, et al. Lung ultrasound can predict the clinical course and severity of COVID-19 disease. Ultrasound Med Biol 2021;47:2090-6.
DOI: https://doi.org/10.1016/j.ultrasmedbio.2021.04.026
Bouhemad B, Mongodi S, Via G, Rouquette I. Ultrasound for "lung monitoring" of ventilated patients. Anesthesiology 2015;122:437-47.
DOI: https://doi.org/10.1097/ALN.0000000000000558
O'Driscoll M, Ribeiro Dos Santos G, Wang L, et al. Age-specific mortality and immunity patterns of SARS-CoV-2. Nature 2021;590:140-5.
DOI: https://doi.org/10.1038/s41586-020-2918-0
Li T, Zheng F, Cheng F. The function of myeloid-derived suppressor cells in COVID-19 lymphopenia. Int Immunopharmacol 2022;112:109277.
DOI: https://doi.org/10.1016/j.intimp.2022.109277
Bonaventura A, Mumoli N, Mazzone A, et al. Correlation of SpO. Intern Emerg Med 2022;17:1769-75.
DOI: https://doi.org/10.1007/s11739-022-02981-3
Secco G, Delorenzo M, Salinaro F, et al. Lung ultrasound presentation of COVID-19 patients: phenotypes and correlations. Intern Emerg Med 2021;16:1317-27.
DOI: https://doi.org/10.1007/s11739-020-02620-9
Boccatonda A, Grignaschi A, Lanotte AMG, et al. Role of Lung Ultrasound in the Management of Patients with Suspected SARS-CoV-2 Infection in the Emergency Department. J Clin Med 2022;11:2067.
DOI: https://doi.org/10.3390/jcm11082067
Boccatonda A, Cocco G, Ianniello E, et al. One year of SARS-CoV-2 and lung ultrasound: what has been learned and future perspectives. J Ultrasound 2021;24:115-23.
DOI: https://doi.org/10.1007/s40477-021-00575-x
Smargiassi A, Soldati G, Torri E, et al. Lung ultrasound for COVID-19 patchy pneumonia: extended or limited evaluations? J Ultrasound Med 2021;40:521-8.
DOI: https://doi.org/10.1002/jum.15428
Song G, Qiao W, Wang X, Yu X. Association of lung ultrasound score with mortality and severity of COVID-19: a meta-analysis and trial sequential analysis. Int J Infect Dis 2021;108:603-9.
DOI: https://doi.org/10.1016/j.ijid.2021.06.026
Gil-Rodríguez J, Pérez de Rojas J, Aranda-Laserna P, et al. Ultrasound findings of lung ultrasonography in COVID-19: A systematic review. Eur J Radiol 2022;148:110156.
DOI: https://doi.org/10.1016/j.ejrad.2022.110156
Rojatti M, Regli IB, Zanforlin A, et al. Lung Ultrasound and Respiratory Pathophysiology in Mechanically Ventilated COVID-19 Patients-an Observational Trial. SN Compr Clin Med 2020;2:1970-7.
DOI: https://doi.org/10.1007/s42399-020-00536-1
Bosso G, Allegorico E, Pagano A, et al. Lung ultrasound as diagnostic tool for SARS-CoV-2 infection. Intern Emerg Med 2021;16:471-6.
DOI: https://doi.org/10.1007/s11739-020-02512-y
Bonadia N, Carnicelli A, Piano A, et al. Lung ultrasound findings are associated with mortality and need for intensive care admission in COVID-19 patients evaluated in the emergency department. Ultrasound Med Biol 2020;46:2927-37.
DOI: https://doi.org/10.1016/j.ultrasmedbio.2020.07.005
Recinella G, Marasco G, Tufoni M, et al. Clinical role of lung ultrasound for the diagnosis and prognosis of coronavirus disease pneumonia in elderly patients: a pivotal study. Gerontology 2021;67:78-86.
DOI: https://doi.org/10.1159/000512209
Boero E, Rovida S, Schreiber A, et al. The COVID-19 Worsening Score (COWS)-a predictive bedside tool for critical illness. Echocardiography 2021;38:207-16.
DOI: https://doi.org/10.1111/echo.14962
Bitar ZI, Shamsah M, Maadarani O, et al. Lung ultrasound and sonographic subpleural consolidation in COVID-19 pneumonia correlate with disease severity. Crit Care Res Pract 2021;2021:6695033.
DOI: https://doi.org/10.1155/2021/6695033
de Alencar JCG, Marchini JFM, Marino LO, et al. Lung ultrasound score predicts outcomes in COVID-19 patients admitted to the emergency department. Ann Intensive Care 2021;11:6.
DOI: https://doi.org/10.1186/s13613-020-00799-w
Wangüemert Pérez AL, Figueira Gonçalves JM, Hernández Pérez JM, et al. Prognostic value of lung ultrasound and its link with inflammatory biomarkers in patients with SARS-CoV-2 infection. Respir Med Res 2021;79:100809.
DOI: https://doi.org/10.1016/j.resmer.2020.100809
Castelao J, Graziani D, Soriano JB, Izquierdo JL. Findings and Prognostic Value of Lung Ultrasound in COVID-19 Pneumonia. J Ultrasound Med 2021;40:1315-24.
DOI: https://doi.org/10.1002/jum.15508
How to Cite
Barbieri, G., De Vuono, S., Gargani, L., Berisha, S., Spinelli, S., Del Carlo, C., Deri, C., D’Angelo, G., Groff, P., & Ghiadoni, L. (2024). Prognostic value of lung ultrasound score performed in the Emergency Department in COVID-19 patients: a prospective multicenter study in central Italy. Emergency Care Journal, 20(1). https://doi.org/10.4081/ecj.2024.12268
Copyright (c) 2024 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Gianmarco Secco, Marzia Delorenzo, Caterina Zattera, Bianca Giacomuzzi Moore, Lorenzo Demitry, Giulia Vezzoni, Flavia Resta, Bruno Barcella, Giovanni Cappa, Tiziano Perrone, Francesco Salinaro, Stefano Perlini, Lung ultrasound in COVID-19: a useful diagnostic tool , Emergency Care Journal: Vol. 16 No. 1 (2020)
You may also start an advanced similarity search for this article.
