276: The Lung Ultrasound Characteristics and Its Predicting Value for COVID-19 in the Early Stage

INTRODUCTION: Coronavirus disease 2019 (COVID-19) is a global pandemic Early diagnosis is crucial for prognosis of patients, and lung ultrasound (LUS) may be a promising technique that can be performed at the bedside We aimed to describe the LUS characteristics and explore its predicting value in assessing the severity and prognosis of COVID-19 patients METHODS: We conducted a retrospective, observational study on patients confirmed with COVID-19 in Wuhan Hankou hospital The patients who underwent LUS examination within 24 hours after being admitted to isolation wards were enrolled The clinical and LUS data were collected and analyzed Patients were divided into three groups (moderate, severe, and critical group) LUS characteristics and its scores were compared in different group of patients and between survivors and non-survivors RESULTS: 42 patients were included, of whom 37 (88 1%) were discharged and 5 (11 9%) died in hospital With the aggravation of lung injury, LUS showed a significantly reduced A-lines and increased coalescent B-lines or consolidation The survivors had 60% of normal aeration with presence of lung sliding with A-lines (survivors 44 3% vs non-survivors 4 0%, P=0 000) or less than three isolated B-lines (survivors 16 2% vs non-survivors 2 0%, P=0 000), while non-survivors lost 90% of lung aeration resulting from coalescent B lines (non-survivors 84 0% vs survivors 18 1%, P=0 000) or lung consolidation (non-survivors 6 0% vs survivors 2 7%, P=0 193) The global LUS scores were significantly higher in non-survivors than survivors (19 00±3 54 vs 6 32±4 96, P=0 000), and in critical ill patients comparing with moderate and severe ill patients (18 5±3 39 vs 8 82±3 89 vs 1 71±1 77, P=0 000) The LUS scores cutoff of 4 5 and 15 0 could identify diffdifferent type of patients with excellent sensitivity, specificity and area under the curve (AUC) In addition, LUS scores more than 17 5 points could predict mortality of COVID-19 patients with AUC 0 975 (95%CI 0 922-1 028), sensitivity 80% and specificity 100% CONCLUSIONS: LUS has a great value for rapid assessment of the severity of lung injury for COVID-19 patients at presentation in the early stage The semiquantitative analysis based on LUS has high diagnostic ability to reflect clinical classification and predict prognosis