Prognostic value of lung ultrasound score performed in the Emergency Department in COVID-19 patients: a prospective multicenter study in central Italy

Greta Barbieri; Stefano De Vuono; Luna Gargani; Sokol Berisha; Stefano Spinelli; Chiara Del Carlo; Chiara Deri; Gennaro D'Angelo; Paolo Groff; Lorenzo Ghiadoni

doi:10.4081/ecj.2024.12268

Authors

Greta Barbieri
greta.barbieri@phd.unipi.it
Emergency Medicine Department, Pisa University Hospital; Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Italy. https://orcid.org/0000-0001-9426-4370
Stefano De Vuono Emergency Department, Santa Maria della Misericordia Hospital, Perugia, Italy. https://orcid.org/0000-0001-6533-5205
Luna Gargani Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Italy. https://orcid.org/0000-0002-0716-453X
Sokol Berisha Emergency Department, Santa Maria della Misericordia Hospital, Perugia, Italy. https://orcid.org/0009-0009-9437-8664
Stefano Spinelli Emergency Medicine Department, Pisa University Hospital, Italy. https://orcid.org/0000-0002-2833-6484
Chiara Del Carlo Emergency Medicine Department, Pisa University Hospital, Italy.
Chiara Deri Emergency Medicine Department, Pisa University Hospital, Italy. https://orcid.org/0000-0001-9197-6268
Gennaro D'Angelo Emergency Medicine Department, Pisa University Hospital, Italy.
Paolo Groff Emergency Department, Santa Maria della Misericordia Hospital, Perugia, Italy.
Lorenzo Ghiadoni Emergency Medicine Department, Pisa University Hospital; Department of Clinical and Experimental Medicine, University of Pisa, Italy.

Lung ultrasound (LUS) is an essential tool for respiratory disease differential diagnosis at Emergency Department (ED), due to easy applicability and safety. During Sars-Cov 2 pandemic, LUS was widely used in every setting. This study aims to demonstrate the prognostic role of LUS independently of other factors and the identification of an LUS score cut-off to be applied in the ED. A multi-center prospective study was conducted on 285 patients, 123 from Pisa University Hospital, 162 from S. Maria Misericordia Hospital of Perugia. All patients received LUS examination by expert sonographers within 48 hours of admission with the same methodology. Univariate logistic analysis demonstrated that LUS is a mortality predictor, OR 2.8 (CL1.5-5.1). Using LUS score cut-off 1.3, the OR was 6.7 (CL2.7-1.6). In multivariate logistic analysis, LUS score significantly predicted death, independently of other factors. ROC curves comparison demonstrated that the introduction of LUS score <1.3 to a multifactorial model improved the association with mortality (AUC 0.76vs0.84, p=0.04). LUS combined with clinical, anamnestic, laboratory, and blood gas parameters, would allow an effective prognostic stratification in Sars-Cov2 patients at ED.

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Barbieri, G., De Vuono, S., Gargani, L., Berisha, S., Spinelli, S., Del Carlo, C., Deri, C., D’Angelo, G., Groff, P., & Ghiadoni, L. (2024). Prognostic value of lung ultrasound score performed in the Emergency Department in COVID-19 patients: a prospective multicenter study in central Italy. Emergency Care Journal, 20(1). https://doi.org/10.4081/ecj.2024.12268