Introduction: Point-of-care ultrasound (POCUS) may detect the cardiopulmonary manifestations of COVID-19 and expediently predict patient outcomes .
Methods: We conducted a prospective cohort study at four medical centers from 3/2020-1/2021 to evaluate POCUS findings and clinical outcomes with COVID-19 . Our inclusion criteria included adult patients hospitalized for COVID-19 who received cardiac or lung POCUS with a 12-zone protocol . Images were interpreted by two reviewers blinded to clinical outcomes . Our primary outcome was ICU admission incidence . Secondary outcomes included intubation and supplemental oxygen usage .
Results: N=160 patients (N=201 scans) were included . Scans were collected a median 23 hours (IQR:7-80) from emergency department triage . Triage POCUS findings associated with ICU admission included B-lines (OR 4.41 [95% CI:1.71-14.30]; p <0.01) or consolidation (OR 2.49 [95% CI:1.35-4.86]; p <0.01). B-lines were associated with intubation (OR 3.10 [95% CI:1.15-10.27]; p=0.02) and supplemental oxygen usage (OR 3.74 [95% CI:1.63-8.63; p <0.01). Consolidations present on triage were associated with the need for oxygen at discharge (OR 2.16 [95% CI : 1.01-4.70]; p=0.047). A normal lung triage scan was protective for ICU admission (OR 0.28 [95% CI:0.09-0.75; p <0.01) or need for supplemental oxygen during the hospitalization (OR 0.26 [95% CI:0.11-0.61]; p <0.01). Triage cardiac POCUS scans were not associated with any outcomes .
Discussion: Lung POCUS findings detected early in the hospitalization may provide expedient risk stratification for important COVID-19 clinical outcomes, including ICU admission, intubation, or need for oxygen on discharge . A normal admission scan appears protective against adverse outcomes, which may aid in triage decisions of patients.