• Medicina clinica · Jun 2023

    Lung ultrasound score severity cut-off points in COVID-19 pneumonia. A systematic review and validating cohort.

    • Jaime Gil-Rodríguez, Michel Martos-Ruiz, Alberto Benavente-Fernández, Pablo Aranda-Laserna, Miguel Ángel Montero-Alonso, José-Antonio Peregrina-Rivas, Daniel Fernández-Reyes, Martínez de Victoria-CarazoJavierJInternal Medicine Unit, San Cecilio University Hospital, Avenida del Conocimiento s/n, 18016 Granada, Spain., Emilio Guirao-Arrabal, and José Hernández-Quero.
    • Internal Medicine Unit, San Cecilio University Hospital, Avenida del Conocimiento s/n, 18016 Granada, Spain.
    • Med Clin (Barc). 2023 Jun 23; 160 (12): 531539531-539.

    ObjectivesOur purpose was to establish different cut-off points based on the lung ultrasound score (LUS) to classify COVID-19 pneumonia severity.MethodsInitially, we conducted a systematic review among previously proposed LUS cut-off points. Then, these results were validated by a single-centre prospective cohort study of adult patients with confirmed SARS-CoV-2 infection. Studied variables were poor outcome (ventilation support, intensive care unit admission or 28-days mortality) and 28-days mortality.ResultsFrom 510 articles, 11 articles were included. Among the cut-off points proposed in the articles included, only the LUS>15 cut-off point could be validated for its original endpoint, demonstrating also the strongest relation with poor outcome (odds ratio [OR]=3.636, confidence interval [CI] 1.411-9.374). Regarding our cohort, 127 patients were admitted. In these patients, LUS was statistically associated with poor outcome (OR=1.303, CI 1.137-1.493), and with 28-days mortality (OR=1.024, CI 1.006-1.042). LUS>15 showed the best diagnostic performance when choosing a single cut-off point in our cohort (area under the curve 0.650). LUS≤7 showed high sensitivity to rule out poor outcome (0.89, CI 0.695-0.955), while LUS>20 revealed high specificity to predict poor outcome (0.86, CI 0.776-0.917).ConclusionsLUS is a good predictor of poor outcome and 28-days mortality in COVID-19. LUS≤7 cut-off point is associated with mild pneumonia, LUS 8-20 with moderate pneumonia and ≥20 with severe pneumonia. If a single cut-off point were used, LUS>15 would be the point which better discriminates mild from severe disease.Copyright © 2023 Elsevier España, S.L.U. All rights reserved.

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