Search

Background: Despite many studies evaluating lung ultrasound (LUS) for coronavirus disease 2019 (COVID-19) prognostication, the generalizability and utility across clinical settings are uncertain., Methods: Adults (≥18 years of age) with COVID-19 were enrolled at 2 military hospitals, an emergency department, home visits, and a homeless shelter in the United States, and in a referral hospital in Uganda. Participants had a 12-zone LUS scan performed at time of enrollment and clips were read off-site. The primary outcome was progression to higher level of care after the ultrasound scan. We calculated the cross-validated area under the curve for the validation cohort for individual LUS features., Results: We enrolled 191 participants with COVID-19 (57.9% female; median age, 45.0 years [interquartile range, 31.5-58.0 years]). Nine participants clinically deteriorated. The top predictors of worsening disease in the validation cohort measured by cross-validated area under the curve were B-lines (0.88 [95% confidence interval {CI}, .87-.90]), discrete B-lines (0.87 [95% CI, .85-.88]), oxygen saturation (0.82 [95%, CI, .81-.84]), and A-lines (0.80 [95% CI, .78-.81])., Conclusions: In an international multisite point-of-care ultrasound cohort, LUS parameters had high discriminative accuracy. Ultrasound can be applied toward triage across a wide breadth of care settings during a pandemic., Competing Interests: Potential conflicts of interest. S. D. P. reports that the USUHS IDCRP, a US DOD institution, and HJF were funded under a cooperative research and development agreement to conduct an unrelated phase 3 COVID-19 monoclonal antibody immunoprophylaxis trial sponsored by AstraZeneca. The HJF, in support of the USUHS IDCRP, was funded by the DOD Joint Program Executive Office for Chemical, Biological, Radiological, and Nuclear Defense to augment the conduct of an unrelated phase 3 vaccine trial sponsored by AstraZeneca. Both of these trials were part of the US government COVID-19 response. Neither is related to the work presented here. T.S. receives consulting feeds from Verona Pharmaceuticals, Apogee Therapeutics, and honoraraia from American Thoracic Society and the COPD foundation. T.S. is an advisor to 4D Medical. C.C. receives consulting fees from Johnson & Johnson and Bayer AG regarding unrelated wearable devices. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)