Combined POCUS and Interventional-Interoperative Scientific Session 1
Lung Ultrasound Does Not Predict Hypoxia in Cohorts of Ambulatory,
Patients with COVID-19
Monday, April 8, 2024
4:32pm – 4:39pm
Location: 410
Authors: Daniel Theodoro, Washington University School of Medicine Di Coneybeare, Columbia University Medical Center Penelope Lema, Columbia University Medical Center Vagelos College of Physicians and Surgeons, Department of Emergency Medicine Nicholas Renz, Washington University in St. Louis Laura Wallace, Washington University in St Louis Srikar Adhikari, University of Arizona Sean Stickles, Washington University School of Medicine in St. Louis Enyo Ablordeppey, Washington University in St Louis Rachel Ancona, Washington University in St. Louis ,
Lung ultrasound was not useful to predict which ambulatory patients with COVID became hypoxic. Early in the pandemic, lung ultrasound reportedly triaged patients who were at risk of respiratory decompensation. However, diagnostic tests behave differently when the intensity of disease varies. We examined how lung ultrasound performed among COVID patients who were not hypoxic and qualified for home care. Our study differed from reported findings by enrolling patients without any signs of respiratory distress or need of oxygen during their presentation to the Emergency Department. We found that, using a widespread scoring rubric, lung pathology detected by ultrasound was no better than clinical gestalt when evaluating non-hypoxic patients. This challenges the paradigm that lung ultrasound findings among patients with viral pneumonia (COVID-19, in this case) are useful markers for patients who do not require oxygen. This is not to say that there is no role for lung ultrasound in these situations, but rather that lung ultrasound may have greater clinical application among patients with severe viral lung disease than in patients with mild disease.