Relationship between lung ultrasound scores and mortality in patients with COVID-19 pneumonia followed in the intensive care unit

Abstract

Lung ultrasound (LUS) is a noninvasive, easily repeatable, and radiation-free technique that can be applied at the bedside and is used increasingly often in patient management. This study aims to examine the relationship between the mortality of patients with COVID-19 pneumonia followed in the intensive care unit and their LUS scores obtained by evaluating different areas of the thorax and to reveal the prognostic value of this method. Fifty patients diagnosed with COVID-19 by PCR tests and followed in our intensive care unit were included in this study. The LUS scores were obtained within 24 hours of the patients' hospitalization. The patients' demographic data, APACHE II and SOFA scores, laboratory data, and survival status were retrospectively reviewed. Comparisons were made according to 28-day mortality. The mortality rate was found to be 31 (62%) among all patients included in the study. The LUS scores of the patients who died were statistically significantly higher than those of patients who survived (30.77 +/- 4.31 vs 24.21 +/- 5.4, P = .001). The APACHE II (P = .001) and SOFA scores (P < .001) and lactate (P = .020) and ferritin (P = .005) levels of the patients who died were also significantly higher. In correlation analysis, LUS scores were positively correlated with APACHE II (R = 0.379, P = .007) and SOFA (R = 0.457, P = .001) scores, while they were negatively correlated with PaO2 (r = -0.483, P = .001) and PaO2/FiO(2) (r = -0.297, P = .036). ROC curve analysis revealed that LUS scores of >= 30 predicted mortality with 80.65% sensitivity and 84.21% specificity (AUC: 0.836, P = .001). The likelihood of observing a LUS score of >= 30 in the patients who died was 22.222 times higher compared to surviving patients (odds ratio for LUS score: 22.222, 95% confidence interval: 4.854-101.741). We determined in this study that LUS scores successfully predicted the prognosis of COVID-19 patients in the intensive care unit. Therefore, the LUS score can provide significant information to clinicians for patient management and the determination of the degree of lung involvement.