Lung Ultrasound Signs and Their Correlation With Clinical Symptoms in COVID-19 Pregnant Women: The PINK-CO Observational Study

Objective: To analyze the application of lung ultrasound (LUS) diagnostic approach in obstetric patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and compare LUS score and symptoms of thepatients. Design: A single-center observational retrospective study from October 31, 2020 to March 31, 2021. Setting: Department of Ob/Gyn at the University-Hospital of Udine, Italy. Participants: Pregnant women with SARS-CoV-2 diagnosed with reverse transcription-PCR (RT-PCR) swab test were subdivided as symptomatic and asymptomatic patients with COVID-19. Exposure: Lung ultrasound evaluation both through initial evaluation upon admission and through serial evaluations. Main Outcome: Reporting LUS findings and LUS score characteristics. Results: Symptomatic patients with COVID-19 showed a higher LUS (median 3.5 vs. 0, p < 0.001). LUS was significantly correlated with COVID-19 biomarkers as C-reactive protein (CPR; p = 0.011), interleukin-6 (p = 0.013), and pro-adrenomedullin (p = 0.02), and inversely related to arterial oxygen saturation (p = 0.004). The most frequent ultrasound findings were focal B lines (14 vs. 2) and the light beam (9 vs. 0). Conclusion:Lung ultrasound can help to manage pregnant women with SARS-CoV-2 infection during a pandemic surge. Study Registration: NCT04823234. Registered on March 29, 2021.

Automated summary

This study analyzed the application of lung ultrasound (LUS) diagnostic approach in pregnant women with SARS-CoV-2 infection. The results showed a positive correlation between LUS score and patient symptoms. LUS was significantly correlated with inflammatory markers and inversely related to arterial oxygen saturation. The most frequently observed ultrasound findings were focal B lines and the light beam.