Alba Hernández-Píriz1, Yale Tung-Chen2, David Jiménez-Virumbrales3, Ibone Ayala-Larrañaga4, Raquel Barba-Martín5, Jesús Canora-Lebrato6, Antonio Zapatero-Gaviria7, Gonzalo García De Casasola-Sánchez8. 1. - Department of Internal Medicine, Hospital Universitario Fuenlabrada, 28942 Fuenlabrada, Madrid, Spain - Department of Medicine, Universidad Rey Juan Carlos, 28933 Móstoles, Madrid, Spain - IFEMA Field Hospital, 28042 Madrid, Spain. ahpiriz@gmail.com. 2. - Department of Internal Medicine, Hospital Universitario Puerta de Hierro, 28222 Majadahonda, Madrid, Spain - Department of Medicine, Universidad Alfonso X, 28691 Villanueva de la Cañada, Madrid, Spain. yale.tung.chen@gmail.com. 3. - Department of Cardiology, Hospital Universitario Severo Ochoa, 28911 Leganés, Spain - IFEMA Field Hospital, 28042 Madrid, Spain. david.jimenez.md@gmail.com. 4. - Department of Internal Medicine, Hospital Universitario Fuenlabrada, 28942 Fuenlabrada, Madrid, Spain. ibone.ayala@salud.madrid.org. 5. - Department of Internal Medicine, Hospital Rey Juan Carlos, 28933 Móstoles, Madrid, Spain - Department of Medicine, Universidad Rey Juan Carlos, 28933 Móstoles, Madrid, Spain - IFEMA Field Hospital, 28042 Madrid, Spain. raquel.barba@hospitalreyjuancarlos.es. 6. - Department of Internal Medicine, Hospital Universitario Fuenlabrada, 28942 Fuenlabrada, Madrid, Spain - Department of Medicine, Universidad Rey Juan Carlos, 28933 Móstoles, Madrid, Spain - IFEMA Field Hospital, 28042 Madrid, Spain. jesus.canora@salud.madrid.org. 7. - Department of Internal Medicine, Hospital Universitario Fuenlabrada, 28942 Fuenlabrada, Madrid, Spain - Department of Medicine, Universidad Rey Juan Carlos, 28933 Móstoles, Madrid, Spain - IFEMA Field Hospital, 28042 Madrid, Spain. antonio.zapatero@salud.madrid.org. 8. - Department of Internal Medicine, Hospital Infanta Cristina, 28981 Parla, Madrid, Spain - IFEMA Field Hospital, 28042 Madrid, Spain. ggcasasolaster@gmail.com.
Abstract
AIM: There is growing evidence regarding the imaging findings of coronavirus disease 2019 (COVID-19) in lung ultrasound (LUS); however, its role in predicting the prognosis has yet to be explored. The aim of the study was to assess the relationship between lung ultrasound findings with the degree of respiratory failure measured by the PaO2/FiO2 ratio (PaFi) andthe prognosis of these patients: need for non-invasive mechanical ventilation (NIMV), admission to the Intensive Care Unit (ICU) and mortality. MATERIAL AND METHOD: Prospective, longitudinal and observational study performed in patients with confirmed COVID-19 underwent a LUS examination and laboratory tests. RESULTS: A total of 107 patients were enrolled: 93.4% with bilateral involvement and 73.83% presented at least one consolidation. A good inverse correlation (Rho Spearman coefficient -0.897) between the ultrasound score and PaFi was obtained. The AUC for identification of patients with more severe respiratory failure, a moderate and severe ARDS, was 0.97 (CI 95%: 0.95-1) and a cut-off score of 34.5 showed a sensitivity of 0.94 and a specificity of 0.91. The Kappa index showed a high concordance (0.83) of the classification by ultrasound lunginvolvement and ARDS. CONCLUSIONS: The combination of the ultrasound score and the presence of respiratory failure can easily identify patients with a higher risk to present complications.
AIM: There is growing evidence regarding the imaging findings of coronavirus disease 2019 (COVID-19) in lung ultrasound (LUS); however, its role in predicting the prognosis has yet to be explored. The aim of the study was to assess the relationship between lung ultrasound findings with the degree of respiratory failure measured by the PaO2/FiO2 ratio (PaFi) andthe prognosis of these patients: need for non-invasive mechanical ventilation (NIMV), admission to the Intensive Care Unit (ICU) and mortality. MATERIAL AND METHOD: Prospective, longitudinal and observational study performed in patients with confirmed COVID-19 underwent a LUS examination and laboratory tests. RESULTS: A total of 107 patients were enrolled: 93.4% with bilateral involvement and 73.83% presented at least one consolidation. A good inverse correlation (Rho Spearman coefficient -0.897) between the ultrasound score and PaFi was obtained. The AUC for identification of patients with more severe respiratory failure, a moderate and severe ARDS, was 0.97 (CI 95%: 0.95-1) and a cut-off score of 34.5 showed a sensitivity of 0.94 and a specificity of 0.91. The Kappa index showed a high concordance (0.83) of the classification by ultrasound lunginvolvement and ARDS. CONCLUSIONS: The combination of the ultrasound score and the presence of respiratory failure can easily identify patients with a higher risk to present complications.