Clinical value of lung ultrasound and X-ray combined with laboratory indices in predicting the prognosis of critical patients with coronavirus disease 2019
Objective To investigating the clinical value of lung ultrasound(LUS)and X-ray combined with laboratory indices in predicting the prognosis of critical patients with coronavirus disease 2019(COVID-19).Methods Sixty-three COVID-19 critically ill patients admitted to the intensive care unit of the Affiliated Hospital of Guizhou Medical University were selected.Bedside LUS(8-zone)and X-ray were performed,the LUS score and X-ray score were obtained after admission.They were divided into 40 cases in the death group and 23 cases in the survival group according to patients'condition after 30 d in the intensive care unit.The LUS score,X-ray score and laboratory indexes were compared between the two groups.Logistic regression analysis was used to evaluate the influencing factors of critically ill patients with COVID-19.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficacy of each influencing factors alone and jointly to predict the prognosis of COVID-19 critically ill patients.Results Leukocyte count,partial pressure of carbon dioxide(PCO2),LUS score and X-ray score were higher in the death group than those in the survival group,and oxygen saturation,the percentage of lymphocytes(LYM%)and acidity and alkalinity(pH)were lower than those in the survival group,the differences were statistically significant(all P<0.05).Logistic regression analysis showed that LUS score,X-ray score,pH,PCO2 and LYM%were influencing factors in predicting the prognosis in COVID-19 critically ill patients(OR=1.22,1.31,0.00,1.08,0.88,all P<0.05).ROC curve analysis showed that the the area under the curve of the combination of X-ray score,LUS score and PCO2 for predicting the prognosis of COVID-19 critical ill patients was 0.791,which was higher than the prediction efficacy alone(0.696,0.708 and 0.715).Conclusion LUS score,X-ray score and PCO2 can be used to predict the prognosis of COVID-19 critically ill patients,and their combined prediction has higher diagnostic efficacy.
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