Lung ultrasound can adequately monitor disease severity in pneumonia and acute respiratory distress syndrome. We hypothesize lung ultrasound can adequately monitor COVID-19 pneumonia in critically ill patients. Adult patients with COVID-19 pneumonia admitted to the intensive care unit of two academic hospitals who underwent a 12-zone lung ultrasound and a chest CT examination were included. Baseline characteristics, and outcomes including composite endpoint death or ICU stay > 30 days were recorded. Lung ultrasound and CT images were quantified as a lung ultrasound score involvement index (LUSI) and CT severity involvement index (CTSI). Primary outcome was the correlation, agreement, and concordance between LUSI and CTSI. Secondary outcome was the association of LUSI and CTSI with the composite endpoints. We included 55 ultrasound examinations in 34 patients, which were 88% were male, with a mean age of 63 years and mean P/F ratio of 151. The correlation between LUSI and CTSI was strong (r = 0.795), with an overall 15% bias, and limits of agreement ranging − 40 to 9.7. Concordance between changes in sequentially measured LUSI and CTSI was 81%. In the univariate model, high involvement on LUSI and CTSI were associated with a composite endpoint. In the multivariate model, LUSI was the only remaining independent predictor. Lung ultrasound can be used as an alternative for chest CT in monitoring COVID-19 pneumonia in critically ill patients as it can quantify pulmonary involvement, register changes over the course of the disease, and predict death or ICU stay > 30 days. Trial registration: NTR, NL8584. Registered 01 May 2020—retrospectively registered, https://www.trialregister.nl/trial/8584

中文翻译：

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肺部超声和计算机断层扫描监测重症患者 COVID-19 肺炎：一项两中心前瞻性队列研究

肺部超声可以充分监测肺炎和急性呼吸窘迫综合征的疾病严重程度。我们假设肺部超声可以充分监测危重患者的 COVID-19 肺炎。纳入了两家学术医院重症监护室收治的成年 COVID-19 肺炎患者，他们接受了 12 区肺部超声检查和胸部 CT 检查。记录基线特征和结果，包括复合终点死亡或 ICU 停留 > 30 天。肺部超声和CT图像被量化为肺部超声评分受累指数（LUSI）和CT严重受累指数（CTSI）。主要结果是 LUSI 和 CTSI 之间的相关性、一致性和一致性。次要结果是 LUSI 和 CTSI 与复合终点的关联。我们纳入了 34 名患者的 55 次超声检查，其中 88% 为男性，平均年龄 63 岁，平均 P/F 比为 151。LUSI 和 CTSI 之间的相关性很强（r = 0.795），总体为 15 % 偏差，一致性限制范围为 − 40 至 9.7。连续测量的 LUSI 和 CTSI 变化之间的一致性为 81%。在单变量模型中，LUSI 和 CTSI 的高度参与与复合终点相关。在多变量模型中，LUSI 是唯一剩下的独立预测因子。肺部超声可作为胸部 CT 的替代方案来监测危重患者的 COVID-19 肺炎，因为它可以量化肺部受累情况，记录病程中的变化，并预测死亡或 ICU 停留时间 > 30 天。试用注册：NTR，NL8584。2020 年 5 月 1 日注册——追溯注册，https://www.Trialregister.nl/Trial/8584