Point-of-care lung ultrasound assessment for risk stratification and therapy guiding in COVID-19 patients. A prospective non-interventional study.

Rubio-Gracia, Jorge (Universidad de Zaragoza) ; Giménez-López, Ignacio (Universidad de Zaragoza) ; Garcés-Horna, Vanessa (Universidad de Zaragoza) ; López-Delgado, Daniel ; Sierra-Monzón, José Luis ; Martínez-Lostao, Luis (Universidad de Zaragoza) ; Josa-Laorden, Claudia (Universidad de Zaragoza) ; Ruiz-Laiglesia, Fernando (Universidad de Zaragoza) ; Pérez-Calvo, Juan Ignacio (Universidad de Zaragoza) ; Crespo-Aznarez, Silvia ; García-Lafuente, J. ; Peña Fresneda, Natacha ; Amores Arriaga, Beatriz (Universidad de Zaragoza) ; Gracia-Tello, Borja ; Sánchez-Marteles, Marta (Universidad de Zaragoza)

Resumen: Background Lung ultrasound is feasible for assessing lung injury caused by coronavirus disease 2019 (COVID-19). However, the prognostic meaning and time-line changes of lung injury assessed by lung ultrasound in COVID-19 hospitalised patients are unknown.

Methods Prospective cohort study designed to analyse prognostic value of lung ultrasound in COVID-19 patients by using a quantitative scale (lung ultrasound Zaragoza (LUZ)-score) during the first 72 h after admission. The primary end-point was in-hospital death and/or admission to the intensive care unit. Total length of hospital stay, increase of oxygen flow and escalation of medical treatment during the first 72 h were secondary end-points.

Results 130 patients were included in the final analysis; mean±sd age was 56.7±13.5 years. Median (interquartile range) time from the beginning of symptoms to admission was 6 (4–9) days. Lung injury assessed by LUZ-score did not differ during the first 72 h (21 (16–26) points at admission versus 20 (16–27) points at 72 h; p=0.183). In univariable logistic regression analysis, estimated arterial oxygen tension/inspiratory oxygen fraction ratio (PAFI) (hazard ratio 0.99, 95% CI 0.98–0.99; p=0.027) and LUZ-score >22 points (5.45, 1.42–20.90; p=0.013) were predictors for the primary end-point.

Conclusions LUZ-score is an easy, simple and fast point-of-care ultrasound tool to identify patients with severe lung injury due to COVID-19, upon admission. Baseline score is predictive of severity along the whole period of hospitalisation. The score facilitates early implementation or intensification of treatment for COVID-19 infection. LUZ-score may be combined with clinical variables (as estimated by PAFI) to further refine risk stratification.

Idioma: Inglés

DOI: 10.1183/13993003.04283-2020

Año: 2021

Publicado en: European respiratory journal 58, 3 (2021), 2004283 [9 pp.]
ISSN: 0903-1936

Factor impacto JCR: 33.801 (2021)

Categ. JCR: RESPIRATORY SYSTEM rank: 2 / 66 = 0.03 (2021) - Q1 - T1

Factor impacto CITESCORE: 18.9 - Medicine (Q1)

Factor impacto SCIMAGO: 4.336 - Pulmonary and Respiratory Medicine (Q1) - Medicine (miscellaneous) (Q1)

Tipo y forma: Artículo (Versión definitiva)

Área (Departamento): Área Fisiología (Dpto. Farmac.Fisiol.y Med.L.F.)
Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)
Área (Departamento): Área Inmunología (Dpto. Microb.Ped.Radio.Sal.Pú.)