The application value of lung ultrasound scoring in assessing disease severity: Evaluation of small-scale outbreaks of COVID-19

Abstract

Purpose: This study explored the use of transthoracic lung ultrasound for evaluating COVID-19 patients, compared it with computed tomography (CT), and examined its effectiveness using 8 and 12 lung regions.

Methods: A total of 100 patients with COVID-19 and 40 healthy volunteers were assessed using 12 regions (bilateral upper/lower regions of the anterior/lateral/posterior chest) and simplified 8 zones (bilateral upper/lower regions of the anterior/lateral chest) transthoracic lung ultrasound. The relationships between ultrasound, CT, and clinical indicators were analyzed to evaluate the diagnostic value of ultrasound scores in COVID-19.

Results: Increased disease severity correlated with increased 8- and 12-zone ultrasound and CT scores (all p < 0.05). The modified 8-zone method strongly correlated with the 12-zone method (Pearson's r = 0.908, p < 0.05). The 8- and 12-zone methods correlated with CT scoring (correlation = 0.568 and 0.635, respectively; p < 0.05). The intragroup correlation coefficients of the 8-zone, 12-zone, and CT scoring methods were highly consistent (intragroup correlation coefficient = 0.718, p < 0.01). The 8-zone ultrasound score correlated negatively with oxygen saturation (r_s = 0.306, p < 0.05) and Ca (r_s = 0.224, p < 0.05) and positively with IL-6 (r_s = 0.0.335, p < 0.05), erythrocyte sedimentation rate (r_s = 0.327, p < 0.05), alanine aminotransferase (r_s = 0.230, p < 0.05), and aspartate aminotransferase (r_s = 0.251, p < 0.05). The 12-zone scoring method correlated negatively with oxygen saturation (r_s = 0.338, p < 0.05) and Ca (r_s = 0.245, p < 0.05) and positively with IL-6 (r_s = 0.354, p < 0.05) and erythrocyte sedimentation rate (r_s = 0.495, p < 0.05).

Conclusion: Lung ultrasound scores represent the clinical severity and have high clinical value for diagnosing COVID-19 pneumonia. The 8-zone scoring method can improve examination efficiency and reduce secondary injuries caused by patient movement.

Keywords: COVID-19; cardiopulmonary function; computed tomography; lung ultrasound; oxygen saturation; scoring method.