Pulmonary Ultrasound, Risk of Intubation and Mortality in Patients with COVID-19 Pneumonia

Abstract

Introduction: COVID-19 causes severe pneumonia that can be fatal. Imaging studies such as Pulmonary Ultrasound (PU) are recommended for a diagnostic and prognostic approach. This is sensitive, specific, and can predict outcomes in COVID-19 pneumonia using the Pulmonary Ultrasound Severity Score (PSUP), which measures loss of lung aeration. Objectives: to evaluate the association and correlation of PSUP with risk of intubation, in-hospital mortality, clinical and laboratory characteristics in patients with COVID-19 pneumonia. Material and methods: cross-sectional study from March to September 2020 in 144 patients from the COVID-19 area of the Roosevelt Hospital. Clinical and laboratory data were collected from admission to hospital discharge or death. The PU was performed following the international protocol of 12 zones. Results: 105 men and 39 women were included. The mean age was 53±12 (SD) years and 6±4 (SD) days from symptom onset at admission. The most frequent comorbidities were systemic arterial hypertension and type 2 diabetes mellitus.
The severity status was severe in 42%. Acute Respiratory Distress syndrome was moderate in 32%. Of the total evaluated, 51 (35.4%) died. A PSUP≥16 points were associated with a higher risk of intubation (RR: 1.53; 95% CI:1.35-1.74) and mortality (RR: 1.64; 95% CI:1.43-1.88). PSUP correlation was negative with SpO2, SaO2/FiO2, PaO2/FiO2 and lymphocyte count (r:-0.32; p<0.005); positive with leukocytes, neutrophils and radioneutrophil lymphocytes (r:0.23; p=0.005). Conclusion: there is an association of the lung ultrasound severity score with the risk of intubation and mortality in patients with COVID-19 pneumonia.