Prognostic implications and utility of LUS scoring
Y Lichter et al found the presence of pleural effusion, pleural
thickening and a high total LUS score at baseline examination were
significantly associated with increased mortality. The unadjusted hazard
ratio of death for patients with LUS score >18 was 2.65
[1.14–6.3], p = 0.02, suggesting a 2.6-fold increase in mortality
in those patients[86]. Extent of lung involvement on LUS was
predictive of the need for intensive care unit admission as noted by
Bonadia N et al, patients admitted to ICU had a median 93% of areas
involved versus 20% of areas involved in patients who did not require
ICU admission[92]. In a study by Zhao L et al., a LUS score cutoff
point of 32 was found to predict refractory disease (defined as
respiratory failure with a PaO2/FiO2 of ≤100 mm Hg or patients who were
treated with ECMO) with a specificity of 89.3% and a sensitivity of
57.1%[93] Description of LUS scores in individual studies is
provided in supplementary Table 2 . Castelao J et al used a
self-designed scoring system to evaluate severity of lung involvement.
The total lung score showed a strong correlation (r = −0.765) with the
oxygen pressure–to–fraction of inspired oxygen ratio, and the anterior
region lung score was significant (OR, 2.159; 95% confidence interval,
1.309–3.561) for the risk of requiring noninvasive respiratory support
(NIRS)[84]. LUS score correlated with IL-6 concentrations (r = 0.52,
p = 0.001) and arterial pCO2 (r = 0.30, p = 0.033) and was inversely
correlated with oxygenation (r = − 0.34, p = 0.001) in mechanically
ventilated patients with COVID-19[94].