Lung ultrasound findings in hospitalized COVID-19 patients in relation to venous thromboembolic events: the ECHOVID-19 study

• Published in: Journal of ultrasound Vol. 25; no. 3; pp. 457 - 467
• Main Authors: Skaarup, Kristoffer Grundtvig, Lassen, Mats Christian Højbjerg, Espersen, Caroline, Lind, Jannie Nørgaard, Johansen, Niklas Dyrby, Sengeløv, Morten, Alhakak, Alia Saed, Nielsen, Anne Bjerg, Ravnkilde, Kirstine, Hauser, Raphael, Schöps, Liv Borum, Holt, Eva, Bundgaard, Henning, Hassager, Christian, Jabbari, Reza, Carlsen, Jørn, Kirk, Ole, Bodtger, Uffe, Lindholm, Matias Greve, Wiese, Lothar, Kristiansen, Ole Peter, Walsted, Emil Schwarz, Nielsen, Olav Wendelboe, Lindegaard, Birgitte, Tønder, Niels, Jeschke, Klaus Nielsen, Ulrik, Charlotte Suppli, Lamberts, Morten, Sivapalan, Pradeesh, Pallisgaard, Jannik, Gislason, Gunnar, Iversen, Kasper, Jensen, Jens Ulrik Stæhr, Schou, Morten, Skaarup, Søren Helbo, Platz, Elke, Biering-Sørensen, Tor
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.09.2022; Springer Nature B.V
• Subjects: Coronaviruses; COVID-19; Hospitalization; Lungs; Medicine; Medicine & Public Health; Thromboembolism; Thrombosis; Ultrasonic imaging; Ultrasound; COVID-19; Venous thromboembolic events; Lung ultrasound; B-lines
• ISSN: 1876-7931; 1971-3495; 1876-7931
• DOI: 10.1007/s40477-021-00605-8

Purpose Several studies have reported thromboembolic events to be common in severe COVID-19 cases. We sought to investigate the relationship between lung ultrasound (LUS) findings in hospitalized COVID-19 patients and the development of venous thromboembolic events (VTE). Methods A total of 203 adults were included from a COVID-19 ward in this prospective multi-center study (mean age 68.6 years, 56.7% men). All patients underwent 8-zone LUS, and all ultrasound images were analyzed off-line blinded. Several LUS findings were investigated (total number of B-lines, B-line score, and LUS-scores). Results Median time from admission to LUS examination was 4 days (IQR: 2, 8). The median number of B-lines was 12 (IQR: 8, 18), and 44 (21.7%) had a positive B-line score. During hospitalization, 17 patients developed VTE (4 deep-vein thrombosis, 15 pulmonary embolism), 12 following and 5 prior to LUS. In fully adjusted multivariable Cox models (excluding participants with VTE prior to LUS), all LUS parameters were significantly associated with VTE (total number of B-lines: HR = 1.14, 95% CI (1.03, 1.26) per 1 B-line increase), positive B-line score: HR = 9.79, 95% CI (1.87, 51.35), and LUS-score: HR = 1.51, 95% CI (1.10, 2.07), per 1-point increase). The B-line score and LUS-score remained significantly associated with VTE in sensitivity analyses. Conclusion In hospitalized COVID-19 patients, pathological LUS findings were common, and the total number of B-lines, B-line score, and LUS-score were all associated with VTE. These findings indicate that the LUS examination may be useful in risk stratification and the clinical management of COVID-19. These findings should be considered hypothesis generating. Clinicaltrials.gov ID NCT04377035