Early assessment of COVID-19 infected dyspneic patients using lung ultrasound score: A prospective, multicenter, observational study

Thibaut MARKARIAN, Nicolas PERSICO, Antoine ROCH, Dalia AHRIZ, Chloe TAGUET, Guillaume BIRMAN, Adela MAHBOUBI, Justine DUCASSOU, Jeremy BOURENNE, Laurent ZIELESKIEWICZ, Xavier BOBBIA, Pierre MICHELET

Resumen


Rationale: The 2019-nCoV pandemic has caused major concerns for medical resources management. In order to rationalize resources, the prognostic rating of affected dyspneic patients is a major issue. The main objective of this study was to evaluate the accuracy of the Modified Lung Ultrasound Score (MLUS) in predicting the respiratory support requirement during the first 48 hours for 2019-nCov dyspneic patients. The secondary objective was to compare MLUS to the National Early Warning Score 2 (NEWS2) score.

Method: A prospective, observational, and multicenter pilot study was conducted. Dyspneic adult patients admitted in emergency departments with positive (RT-PCR) diagnosis were included. Patients benefited from an early lung ultrasound assessment with MLUS calculation. Patients were classified as Low (LR), Intermediate (IR), or High risk (HR) based on the level of respiratory support required: none (LR), oxygen supply only (IR), or non-invasive/mechanical ventilation (HR) during the first 48 hours.

Results: 100 patients were included: 35 (35%) categorized as LR, and 29 (29%) as HR. The area under the ROC (AUC ROC) of the MLUS for predicting the LR group was 0.96 [0.93; 0.99], whereas the AUC ROC of the NEWS 2 was 0.88 [0.82; 0.95] (p = 0.04). Concerning the HR patients, the AUC ROC of the MLUS was 0.93 [0.88; 0.98], whereas the AUC ROC of the NEWS 2 was 0.89 [0.83; 0.95] (p = 0.32).

Conclusion: An early lung ultrasound score may predict the oxygen requirement and need for ventilation during the first 48 hours in dyspneic patients infected with COVID-19

Palabras Clave


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