Concise Versus Extended Lung Ultrasound Score to Monitor Critically Ill Patients With COVID-19

Area of Science:

• Critical care medicine
• Pulmonary imaging
• Infectious disease diagnostics

Background:

• Lung ultrasound (LUS) is valuable for monitoring critically ill COVID-19 patients.
• The optimal number of lung zones for LUS assessment remains debated.

Purpose of the Study:

• To compare the clinical equivalence of concise (6 zones) and extended (12 zones) LUS scoring protocols.
• To evaluate LUS scoring agreement between protocols in supine and prone positions.

Main Methods:

• Prospective observational study including 130 LUS examinations in 40 critically ill COVID-19 patients.
• Statistical agreement assessed using correlation coefficients and Bland-Altman plots.
• Secondary analysis compared LUS scores between supine and prone positions.

Main Results:

• Excellent agreement between concise and extended LUS scores with no clinically significant bias.
• LUS scores were 8% higher in the supine position compared to the prone position.
• High inter-rater and intra-rater reliability were observed.

Conclusions:

• Concise LUS protocols are as informative as extended protocols for COVID-19 patient monitoring.
• Clinicians should consider positional changes when interpreting LUS score alterations.
• LUS is a reliable tool for tracking disease progression or improvement in critically ill patients.