Lung Ultrasound Findings Associated With COVID-19 ARDS, ICU Admission, and All-Cause Mortality
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Lung Ultrasound Findings Associated With COVID-19 ARDS, ICU Admission, and All-Cause Mortality. / Espersen, Caroline; Platz, Elke; Skaarup, Kristoffer Grundtvig; Lassen, Mats Christian Hojbjerg; Lind, Jannie Norgaard; Johansen, Niklas Dyrby; Sengelov, Morten; Alhakak, Alia Saed; Nielsen, Anne Bjerg; Bundgaard, Henning; Hassager, Christian; Jabbari, Reza; Carlsen, Jorn; Kirk, Ole; Lindholm, Matias Greve; Kristiansen, Ole Peter; Nielsen, Olav Wendelboe; Jeschke, Klaus Nielsen; Ulrik, Charlotte Suppli; Sivapalan, Pradeesh; Gislason, Gunnar; Iversen, Kasper; Jensen, Jens Ulrik Staehr; Schou, Morten; Skaarup, Soren Helbo; Biering-Sorensen, Tor.
In: Respiratory Care, Vol. 67, No. 1, 2022, p. 66-75.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Lung Ultrasound Findings Associated With COVID-19 ARDS, ICU Admission, and All-Cause Mortality
AU - Espersen, Caroline
AU - Platz, Elke
AU - Skaarup, Kristoffer Grundtvig
AU - Lassen, Mats Christian Hojbjerg
AU - Lind, Jannie Norgaard
AU - Johansen, Niklas Dyrby
AU - Sengelov, Morten
AU - Alhakak, Alia Saed
AU - Nielsen, Anne Bjerg
AU - Bundgaard, Henning
AU - Hassager, Christian
AU - Jabbari, Reza
AU - Carlsen, Jorn
AU - Kirk, Ole
AU - Lindholm, Matias Greve
AU - Kristiansen, Ole Peter
AU - Nielsen, Olav Wendelboe
AU - Jeschke, Klaus Nielsen
AU - Ulrik, Charlotte Suppli
AU - Sivapalan, Pradeesh
AU - Gislason, Gunnar
AU - Iversen, Kasper
AU - Jensen, Jens Ulrik Staehr
AU - Schou, Morten
AU - Skaarup, Soren Helbo
AU - Biering-Sorensen, Tor
PY - 2022
Y1 - 2022
N2 - BACKGROUND: As lung ultrasound (LUS) has emerged as a diagnostic tool in patients with COVID-19, we sought to investigate the association between LUS findings and the composite inhospital outcome of ARDS incidence, ICU admission, and all-cause mortality. METHODS: In this prospective, multi-center, observational study, adults with laboratory-confirmed SARS-CoV-2 infection were enrolled from non-ICU in-patient units. Subjects underwent an LUS evaluating a total of 8 zones. Images were analyzed off-line, blinded to clinical variables and outcomes. A LUS score was developed to integrate LUS findings: >= 3 B-lines corresponded to a score of 1, confluent B-lines to a score of 2, and subpleural or lobar consolidation to a score of 3. The total LUS score ranged from 0-24 per subject. RESULTS: Among 215 enrolled subjects, 168 with LUS data and no current signs of ARDS or ICU admission (mean age 59 y, 56% male) were included. One hundred thirty-six (81%) subjects had pathologic LUS findings in >= 1 zone (>= 3 B-lines, confluent B- lines, or consolidations). Markers of disease severity at baseline were higher in subjects with the composite outcome (n = 31, 18%), including higher median C-reactive protein (90 mg/L vs 55, P < .001) and procalcitonin levels (0.35 mu g/L vs 0.13, P = .033) and higher supplemental oxygen requirements (median 4 L/min vs 2, P = .001). However, LUS findings and score did not differ significantly between subjects with the composite outcome and those without, and were not associated with outcomes in unadjusted and adjusted logistic regression analyses. CONCLUSIONS: Pathologic findings on LUS were common a median of 3 d after admission in this cohort of nonICU hospitalized subjects with COVID-19 and did not differ among subjects who experienced the composite outcome of incident ARDS, ICU admission, and all-cause mortality compared to subjects who did not. These findings should be confirmed in future investigations. The study is registered at Clinicaltrials.gov (NCT04377035).
AB - BACKGROUND: As lung ultrasound (LUS) has emerged as a diagnostic tool in patients with COVID-19, we sought to investigate the association between LUS findings and the composite inhospital outcome of ARDS incidence, ICU admission, and all-cause mortality. METHODS: In this prospective, multi-center, observational study, adults with laboratory-confirmed SARS-CoV-2 infection were enrolled from non-ICU in-patient units. Subjects underwent an LUS evaluating a total of 8 zones. Images were analyzed off-line, blinded to clinical variables and outcomes. A LUS score was developed to integrate LUS findings: >= 3 B-lines corresponded to a score of 1, confluent B-lines to a score of 2, and subpleural or lobar consolidation to a score of 3. The total LUS score ranged from 0-24 per subject. RESULTS: Among 215 enrolled subjects, 168 with LUS data and no current signs of ARDS or ICU admission (mean age 59 y, 56% male) were included. One hundred thirty-six (81%) subjects had pathologic LUS findings in >= 1 zone (>= 3 B-lines, confluent B- lines, or consolidations). Markers of disease severity at baseline were higher in subjects with the composite outcome (n = 31, 18%), including higher median C-reactive protein (90 mg/L vs 55, P < .001) and procalcitonin levels (0.35 mu g/L vs 0.13, P = .033) and higher supplemental oxygen requirements (median 4 L/min vs 2, P = .001). However, LUS findings and score did not differ significantly between subjects with the composite outcome and those without, and were not associated with outcomes in unadjusted and adjusted logistic regression analyses. CONCLUSIONS: Pathologic findings on LUS were common a median of 3 d after admission in this cohort of nonICU hospitalized subjects with COVID-19 and did not differ among subjects who experienced the composite outcome of incident ARDS, ICU admission, and all-cause mortality compared to subjects who did not. These findings should be confirmed in future investigations. The study is registered at Clinicaltrials.gov (NCT04377035).
KW - COVID-19
KW - lung ultrasound
KW - risk stratification
KW - in-hospital outcomes
KW - RESPIRATORY-DISTRESS-SYNDROME
KW - HOSPITALIZED-PATIENTS
KW - CRITICALLY-ILL
KW - HEART-FAILURE
KW - DIAGNOSIS
KW - ULTRASONOGRAPHY
U2 - 10.4187/respcare.09108
DO - 10.4187/respcare.09108
M3 - Journal article
C2 - 34815326
VL - 67
SP - 66
EP - 75
JO - Respiratory Care
JF - Respiratory Care
SN - 0020-1324
IS - 1
ER -
ID: 291539995