289: Should We Count the Sonographic Subpleural Consolidation in COVID-19 Pneumonia?

Abstract

INTRODUCTION: Lung ultrasound (LUS) was used in COVID-19 pneumonia in case of identification, disease severity classification, and treatment allocation (1) For the severity of the disease, they mainly used the B lines as percentages in each field of the examined chest area (aeration score) (2) The correlation between the number of subpleural consolidation (SPC)and the severity of COVID-19 pneumonia was not studied METHODS: The study is an observational, prospective, single-center study conducted in the intensive care unit of Adan General Hospital, Kuwait, from May 1, 2020, to June 30, 2020 Patients were included if they were age >18 with suspicion of COVID-19 infection and had been transferred to the ICU with a suspected respiratory infection (3) Polymerase chain reaction (RT-PCR) had been performed;every patient admitted to ICU We performed lung ultrasonography for every patient admitted to the ICU using a 12-zone method (2) The signs of the high probability of COVID-19 pneumonia on lung ultrasound were documented (1) We calculated the aeration score and total number of SPCs in each area of the chest in 12 zones protocol and correlate it with PaO2/ FiO2 RESULTS: Of 109 patients with suspected COVID-19 pneumonia, 77 (71%) were confirmed The patients' median age was 53 (82-36) years, and 81 (73 7%) were men The clinical characteristics of the patients with confirmed COVID-19 pneumonia are shown in Table 1 The aeration score was significantly higher COVID-19 pneumonia (P0 018) and counting SPCs in each zone was significantly higher in COVID19 pneumonia (P>0 0001) There is an inverse relation between PO2/fiO2 and aeration score and SPC number The higher number of SPC, the lower the ratio (figure 1,2) The mean aeration score in COVID-19 pneumonia was 27 compared to the non-COVID group was 21 (P=0 018) The mean SPC score is 13 in COVID-19 pneumonia compared to non-COVID 1 (P<0 0001) There was no difference in the SOFA score LUS revealed the signs of the high probability of COVID-19 pneumonia in 75 (97 4%) (sensitivity 96 9%, CI 85%-99 5%) CONCLUSIONS: The LUS aeration score, as well as the SPC score, correlates with the severity of COVID-19 pneumonia at a presentation in the ICU A higher elevated LUS aeration and SPC score on admission are associated with lower PO2 / FiO2