Association of Lung Ultrasound Score with Mortality and Severity of COVID-19: A Meta-Analysis and Trial Sequential Analysis

Guang Song, Wei Qiao, Xin Wang, Xiaona Yu, Guang Song, Wei Qiao, Xin Wang, Xiaona Yu

Abstract

Objectives: The coronavirus disease 2019 (COVID-19) pandemic has rapidly spread all over the world. Lung ultrasound (LUS) has emerged as a useful tool for diagnosing many respiratory diseases. The prognostic role of LUS in COVID-19 patients has not yet been established.

Methods: Several databases were searched on 09 April 2021. The difference in LUS score between the death and survival groups, and the relationship between LUS score and COVID-19 severity were both assessed.

Results: The LUS score was significantly higher in the death group compared with the survival group (weighted mean difference (WMD) = 8.21, 95% CI: 4.74-11.67, P < 0.001), which was confirmed by trial sequential analysis. Those with mild/moderate, severe and critical COVID-19 had a progressively higher LUS score (critical vs. severe: WMD = 8.78, 95% CI: 4.17-13.38; P < 0.001; critical vs. mild/moderate/severe: WMD = 10.00, 95% CI: 6.83-13.17, P < 0.001; severe vs. moderate: WMD = 5.96, 95% CI: 3.48-8.44, P < 0.001; severe vs. mild/moderate: WMD = 7.31, 95% CI: 4.45-10.17, P < 0.001).

Conclusions: The LUS score was associated with mortality and severity of COVID-19. The LUS score might be a risk stratification tool for COVID-19 patients.

Keywords: COVID-19; Lung ultrasound score; Meta-analysis; Mortality; Severity.

Conflict of interest statement

Conflict of interest None declare.

Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Figures

Figure 1
Figure 1
Flow-chart of study selection. LUSS, lung ultrasound score
Figure 2
Figure 2
Forest plots for lung ultrasound score between the death and survival groups of COVID-19 patients.
Figure 3
Figure 3
Subgroup analysis of weighted mean difference (WMD) in lung ultrasound score between different severities of COVID-19.
Figure 4
Figure 4
Comparison of the lung ultrasound score between death and survival groups by trial sequential analysis.

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