Introduction: Lung ultrasound (LUS) has emerged as a promising tool for the assessment of patients with respiratory failure in the intensive care unit (ICU). A caveat for the wide implementation of LUS is its operator-dependency.

Aims and Objectives: To assess the utility of LUS in real-life conditions.

Methods: The multicentre Greek RECUP-19 database was used that prospectively follows patients with COVID-19 pneumonia hospitalized in ICU. LUS was performed as part of the clinical evaluation upon admission. Six regions (upper/lower at the mid-clavicular, mid-axillary and posterior axillary lines) were scanned in each hemithorax and a score was applied (0=normal, 1= multiple discrete B-lines, 2=coalescent B-lines, 3=consolidation). 28-day mortality, static compliance (Cst), the P:F ratio and serum CRP were recorded. Data are presented as median (IQR) and were analyzed with the Mann-Whitney U test and the Spearman rank correlation.

Results: 29 patients were included [age 72 (57-76)]. The LUS score was not significantly different between survivors (65.5% of patients) and non-survivors (34.5%) [score, 19 (11-24) vs 23.5 (21-25), p=0.16, respectively]. LUS score was positively correlated with the APACHE-II score (r=0.42, p=0.02) and negatively correlated with Cst (r=-0.37, p=0.04). LUS score was not correlated with the P:F ratio or CRP (r=-0.003, p=0.98 and r=0.33, p=0.10, respectively). Patients with Cst?40 mL/cmH2O had a lower score mainly at the anterior segments of the lungs, compared to Cst<40 [score, 4 (3-4) vs 8 (5.5-8), p=0.007].

Conclusion: LUS is a useful tool for the evaluation of patients with COVID-19 pneumonia in the ICU that can be implemented in daily clinical practice.