Repeated Lung Ultrasound versus Chest X-ray-Which One Predicts Better Clinical Outcome in COVID-19?

The purpose of this study was to evaluate whether changes in repeated lung ultrasound (LUS) or chest X-ray (CXR) of coronavirus disease 2019 (COVID-19) patients can predict the development of severe disease and the need for treatment in the intensive care unit (ICU). In this prospective monocentric...

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Bibliographic Details
Published in:Tomography (Ann Arbor) 2023-03, Vol.9 (2), p.706-716
Main Authors: Spogis, Jakob, Fusco, Stefano, Hagen, Florian, Kaufmann, Sascha, Malek, Nisar, Hoffmann, Tatjana
Format: Article
Language:English
Subjects:
Comparative analysis
Coronaviruses
COVID-19
COVID-19 - diagnostic imaging
critical care
Hospital patients
Humans
intensive care
Lung - diagnostic imaging
lung ultrasound
Medical research
Medicine, Experimental
Patient outcomes
Prognosis
Prospective Studies
Respiratory Sounds
X-ray
X-Rays
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Summary:The purpose of this study was to evaluate whether changes in repeated lung ultrasound (LUS) or chest X-ray (CXR) of coronavirus disease 2019 (COVID-19) patients can predict the development of severe disease and the need for treatment in the intensive care unit (ICU). In this prospective monocentric study, COVID-19 patients received standardized LUS and CXR at day 1, 3 and 5. Scores for changes in LUS (LUS score) and CXR (RALE and M-RALE) were calculated and compared. Intra-class correlation was calculated for two readers of CXR and ROC analysis to evaluate the best discriminator for the need for ICU treatment. A total of 30 patients were analyzed, 26 patients with follow-up LUS and CXR. Increase in M-RALE between baseline and follow-up 1 was significantly higher in patients with need for ICU treatment in the further hospital stay ( = 0.008). Both RALE and M-RALE significantly correlated with LUS score (r = 0.5, < 0.0001). ROC curves with need for ICU treatment as separator were not significantly different for changes in M-RALE (AUC: 0.87) and LUS score (AUC: 0.79), both being good discriminators. ICC was moderate for RALE (0.56) and substantial for M-RALE (0.74). The present study demonstrates that both follow-up LUS and CXR are powerful tools to track the evolution of COVID-19, and can be used equally as predictors for the need for ICU treatment.
ISSN:2379-139X
2379-1381
2379-139X
DOI:10.3390/tomography9020056