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Early lung ultrasound assessment for the prognosis of patients hospitalized for COVID-19 pneumonia. A pilot study - 04/06/21

Doi : 10.1016/j.resmer.2021.100832 
Alexandros Kalkanis, MD PhD 1, , Els Wauters, MD PhD 1, Dries Testelmans, MD PhD 1, Jonas Yserbyt, MD PhD 1, Natalie Lorent, MD PhD 1, Zafeiris Louvaris, PhD 1, 2, Laurent Godinas, MD PhD 1, Pierre Van Mol, MD 1, 3, Joost Wauters, MD PhD 4, Mavroudis Eleftheriou, MD PhD 5, Christophe Dooms, MD PhD 1
1 Department of Respiratory Diseases, University Hospitals KU Leuven, Leuven, Belgium 
2 Faculty of Movement and Rehabilitation Sciences, Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders, KU Leuven, Belgium 
3 Laboratory of Translational Genetics, VIB - KU Leuven Center for Cancer Biology, Herestraat 49 b912, 3000 Leuven, Belgium 
4 Department of Internal Medicine, University Hospitals KU Leuven, Leuven, Belgium 
5 Aristotle University of Thessaloniki, Department of Mathematics, Thessaloniki, Greece 

Corresponding author: Department of Respiratory Diseases University Hospitals KU Leuven, Herestraat 49, B-3000 Leuven, BelgiumDepartment of Respiratory Diseases University Hospitals KU LeuvenHerestraat 49LeuvenB-3000Belgium

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En prensa. Manuscrito Aceptado. Disponible en línea desde el Friday 04 June 2021

Abstract

Objective: SARS CoV-2 is an epidemic viral infection that can cause mild to severe lung involvement. Newly apprehended knowledge on thoracic imaging abnormalities and the growing clinical experience on the evolution of this disease make the radiographic follow-up of hospitalized patients relevant. The value of consecutive bedside lung ultrasonography in the follow-up of hospitalized patients with SARS CoV-2 pneumonia and its correlation with other clinical and laboratory markers needs to be evaluated.

Methods: We assessed 39 patients [age: 64 y(60.1 - 68.7)] with confirmed SARS CoV-2 pneumonia. 24 patients were hospitalized until the follow-up test, 9 were discharged early and 6 required a transfer to critical care unit. Two ultrasound scans of the lung were performed on day 1 and 4 of patients´ hospitalization. Primary endpoint was the magnitude of association between a global lung ultrasound score (LUS) and clinical and laboratory markers. Secondary endpoint was the association between the evolution of LUS with the corresponded changes in clinical and laboratory outcomes during hospitalization period.

Results: LUS score on admission was higher among the deteriorating patients and significantly (p=0.038-0.0001) correlated (Spearman’s rho) with the levels of C-reactive protein (0.58), lymphocytes (-0.33), SpO2 (-0.48) and oxygen supplementation (0.48) upon admission. The increase in LUS score between the two scans was significantly correlated (0.544, p=0.006) with longer hospital stay.

Conclusion: Lung ultrasound assessment can be a useful as an imaging modality for SARS CoV-2 patients. Larger studies are needed to further investigate the predictive role of LUS in the duration and the outcome of the hospitalization of these patients.

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Keywords : biomarkers, COVID-19, prognosis, ultrasonography



© 2021  SPLF and Elsevier Masson SAS. Reservados todos los derechos.
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