AUTHOR=Blair Paul W. , Hwang Jimin , Pearce Jackson , Fong Tiffany C. , Cui Erjia , Herrera Phabiola , Liu Gigi , Crainiceanu Ciprian , Siddharthan Trishul , Clark Danielle V. ,  The CCPSEI Research Team , Fenstermacher Katherine , Shea Sophia , Seo Stefanie , Lawrence Josh , Sauer Lauren , Hansoti Bhakti , Rothman Richard 

TITLE=Do worsening lung ultrasound scans identify severe COVID-19 trajectories?

JOURNAL=Frontiers in Medicine

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.1021929

DOI=10.3389/fmed.2022.1021929

ISSN=2296-858X

ABSTRACT=<sec><title>Background</title><p>While point-of-care ultrasound (POCUS) has been used to track worsening COVID-19 disease it is unclear if there are dynamic differences between severity trajectories.</p></sec><sec><title>Methods</title><p>We studied 12-lung zone protocol scans from 244 participants [with repeat scans obtained in 3 days (<italic>N</italic> = 114), 7 days (<italic>N</italic> = 53), and weekly (<italic>N</italic> = 9)] ≥ 18 years of age hospitalized for COVID-19 pneumonia. Differences in mean lung ultrasound (LUS) scores and percent of lung fields with A-lines over time were compared between peak severity levels (as defined by the WHO clinical progression scale) using linear mixed-effects models.</p></sec><sec><title>Results</title><p>Mean LUS scores were elevated by 0.19 (<italic>p</italic> = 0.035) and A-lines were present in 14.7% fewer lung fields (<italic>p</italic> = 0.02) among those with ICU-level or fatal peak illness compared to less severe hospitalized illness, regardless of duration of illness. There were no differences between severity groups in the trajectories of mean LUS score 0.19 (<italic>p</italic> = 0.66) or percent A-lines (<italic>p</italic> = 0.40).</p></sec><sec><title>Discussion</title><p>Our results do not support the use of serial LUS scans to monitor COVID-19 disease progression among hospitalized adults.</p></sec>