Lung ultrasound is feasible for assessing lung injury caused by coronavirus disease 2019 (COVID-19). However, the prognostic meaning and time-line changes of lung injury assessed by lung ultrasound in COVID-19 hospitalised patients are unknown.

Prospective cohort study designed to analyse prognostic value of lung ultrasound in COVID-19 patients by using a quantitative scale (lung ultrasound Zaragoza (LUZ)-score) during the first 72 h after admission. The primary end-point was in-hospital death and/or admission to the intensive care unit. Total length of hospital stay, increase of oxygen flow and escalation of medical treatment during the first 72 h were secondary end-points.

130 patients were included in the final analysis; mean±sd age was 56.7±13.5 years. Median (interquartile range) time from the beginning of symptoms to admission was 6 (4–9) days. Lung injury assessed by LUZ-score did not differ during the first 72 h (21 (16–26) points at admission versus 20 (16–27) points at 72 h; p=0.183). In univariable logistic regression analysis, estimated arterial oxygen tension/inspiratory oxygen fraction ratio (PAFI) (hazard ratio 0.99, 95% CI 0.98–0.99; p=0.027) and LUZ-score >22 points (5.45, 1.42–20.90; p=0.013) were predictors for the primary end-point.

LUZ-score is an easy, simple and fast point-of-care ultrasound tool to identify patients with severe lung injury due to COVID-19, upon admission. Baseline score is predictive of severity along the whole period of hospitalisation. The score facilitates early implementation or intensification of treatment for COVID-19 infection. LUZ-score may be combined with clinical variables (as estimated by PAFI) to further refine risk stratification.

肺部超声可用于评估 2019 年冠状病毒病 (COVID-19) 引起的肺损伤。然而，通过肺部超声评估的 COVID-19 住院患者肺损伤的预后意义和时间线变化尚不清楚。

前瞻性队列研究旨在通过使用定量量表（肺部超声萨拉戈萨（LUZ）评分）来分析入院后前 72 小时内肺部超声对 COVID-19 患者的预后价值。主要终点是院内死亡和/或入住重症监护室。住院总时间、氧流量的增加和前 72 小时内医疗治疗的升级是次要终点。

最终纳入130例患者分析；平均值±标准差年龄为56.7±13.5岁。从出现症状到入院的中位时间（四分位距）为 6 (4–9) 天。通过 LUZ 评分评估的肺损伤在前 72 小时内没有差异（入院时为 21 (16–26) 分， 72 小时时为20 (16–27) 分；p=0.183）。在单变量逻辑回归分析中，估计动脉氧分压/吸气氧分数比 (PAFI)（风险比 0.99，95% CI 0.98–0.99；p=0.027）和 LUZ 评分 >22 分（5.45，1.42–20.90；p= 0.013）是主要终点的预测因子。

LUZ-score 是一种简单、简单且快速的床旁超声工具，可在入院时识别因 COVID-19 导致严重肺损伤的患者。基线评分可预测整个住院期间的严重程度。该评分有助于尽早实施或强化针对 COVID-19 感染的治疗。LUZ 评分可以与临床变量（由 PAFI 估计）相结合，以进一步细化风险分层。