Do worsening lung ultrasound scans identify severe COVID-19 trajectories?

BackgroundWhile point-of-care ultrasound (POCUS) has been used to track worsening COVID-19 disease it is unclear if there are dynamic differences between severity trajectories. MethodsWe studied 12-lung zone protocol scans from 244 participants [with repeat scans obtained in 3 days (N = 114), 7 days (N = 53), and weekly (N = 9)] >= 18 years of age hospitalized for COVID-19 pneumonia. Differences in mean lung ultrasound (LUS) scores and percent of lung fields with A-lines over time were compared between peak severity levels (as defined by the WHO clinical progression scale) using linear mixed-effects models. ResultsMean LUS scores were elevated by 0.19 (p = 0.035) and A-lines were present in 14.7% fewer lung fields (p = 0.02) among those with ICU-level or fatal peak illness compared to less severe hospitalized illness, regardless of duration of illness. There were no differences between severity groups in the trajectories of mean LUS score 0.19 (p = 0.66) or percent A-lines (p = 0.40). DiscussionOur results do not support the use of serial LUS scans to monitor COVID-19 disease progression among hospitalized adults.

Automated summary

The study found that COVID-19 patients with ICU-level or fatal peak illness had higher mean lung ultrasound scores and lower percentage of lung fields with A-lines compared to those with less severe hospitalized illness, regardless of the duration of illness. However, there were no differences in the trajectories of mean lung ultrasound scores and percentage of lung fields with A-lines between severity groups. Therefore, serial lung ultrasound scans may not be useful in monitoring the progression of COVID-19 in hospitalized adults.