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Background  The role of lung ultrasound (LUS) in evaluating the mid- and long-term prognoses of patients with COVID-19 pneumonia is not yet known. The objectives of this study were to evaluate associations between LUS signs at the time of screening and clinical outcomes 1 month after LUS and to assess LUS signs at the time of presentation with known risk factors for COVID-19 pneumonia.    Methods  This was a retrospective study of data prospectively collected 1 month after LUS screening of 447 adult patients diagnosed with COVID-19 pneumonia. Sonographic examination was performed in screening tents with the participants seated. The LUS signs (B-lines > 2, coalescent B-lines, and subpleural consolidations) were captured in six areas of each hemithorax and a LUS aeration score was calculated; in addition, the categories of disease probability based on patterns of LUS findings (high-probability, intermediate-probability, alternate, and low-probability patterns) were evaluated. The LUS signs at patients’ initial evaluation were related to the following outcomes: symptomatology, the need for hospitalization or invasive mechanical ventilation (IMV), and COVID-19-related death.    Results  According to the evaluations performed 1 month after LUS screening, 36 patients were hospitalised, eight of whom required intensive care unit (ICU) admission and three of whom died. The presence of coalescent B-lines was associated with the need for hospitalization ( p  = 0.008). The presence of subpleural consolidations was associated with dyspnoea ( p  < 0.0001), cough ( p  = 0.003), the need for hospitalization ( p  < 0.0001), the need for ICU admission ( p  < 0.0001), and death ( p  = 0.002). A higher aeration score was associated with dyspnoea ( p  < 0.0001), the need for hospitalization ( p  < 0.0001), the need for ICU admission ( p  < 0.0001), and death ( p  = 0.003). In addition, patients with a high-probability LUS pattern had a higher aeration score ( p  < 0.0001) and more dyspnoea ( p  = 0.024) and more often required hospitalization ( p  < 0.0001) and ICU admission ( p  = 0.031).    Conclusions  In patients with COVID-19 pneumonia, LUS signs were related to respiratory symptoms 1 month after LUS screening. Strong relationships were identified between LUS signs and the need for hospitalization and death.

One-month outcomes of patients with SARS-CoV-2 infection and their relationships with lung ultrasound signs