Role of Lung Ultrasound in the Management of Patients with Suspected SARS-Cov-2 Infection in the Emergency Department (preprint)

ABSTRACT

Background: the LUS score has been proposed as an optimal scheme for the ultrasound study of the patient with suspected / confirmed COVID-19 pneumonia. The aim of our study was to evaluate the use of lung ultrasound as a diagnostic tool for diagnosing SARS-CoV-2 pneumonia, and to examine the validity of LUS score for the diagnosis of COVID-19 pneumonia, and to correlate with hospitalization rate and 30-days mortality.Material & methods: a retrospective analysis was performed on all patients who were referred to the General Emergency Department of the S. Orsola-Malpighi Hospital from April 2020 to May 2020 for symptoms suspected for SARS-CoV-2 infection. The ultrasound examination was based on a common execution scheme called LUS score, as previously described.Results & Conclusions: LUS score correlates with the degree of clinical severity and respiratory failure (P/F ratio, Delta (A-a), Delta (A-a) increase). COVID-19 patients with a LUS score > 7 require the use of oxygen support; a value > 10 is associated with an increased risk of oro-tracheal intubation. The LUS score presents higher values in hospitalized patients, increasing according to the degree of care intensity. COVID-19 died patients were characterized by a mean LUS score of 11 at presentation to the emergency department. A LUS score value > 7.5 displays a sensitivity of 83% and specificity of 89% against 30-days mortality in COVID-19 patients. Lung ultrasound seems to be an optimal first level method for pneumonia detection in patients with suspected SARS-CoV-2 infection.