Usefulness of Lung Ultrasound in Older Patients with Asymptomatic COVID-19 Pneumonia: Bicentric 3-month Follow-up Study

BACKGROUND: Clinical and prognosticdifferencesbetweensymptomatic and asymptomaticolderpatients with COVID-19 are of greatinterestsincefrailpatientsoften show atypicalpresentation of illness.LungUltrasound (LUS) hasbeenproven to be a reliable tool for detectingearly-phase COVID-19 pneumonicalterations. The current study aimed to compare LUS score and 3-month overall mortalitybetweenasymptomatic and symptomaticolderpatients with COVID-19, according to frailty status. METHODS: Bicentric prospective study onolder patients with asymptomatic and symptomaticCOVID-19 disease.Patients were stratified according to LUS score tertiles and Clinical Frailty Scale categories.Survival rate was assessed by telephone interviews 3months afterdischarge. RESULTS 64 symptomatic (24women, aged 80.0±10.8 years) and46asymptomatic (31 women; aged 84.3±8.8 years) were consecutively enrolled. LUS score resulted an independent predictor of 3-month mortality [OR2.27 (CI95%: 1.09-4.8), p=0.03], andthe highest mortality rate was observed in symptomatic and asymptomatic pre-frail and frail patients (70.6% and 66.7%, respectively)withgreater LUS abnormalities (3 rd tertile). CONCLUSIONS LUS identified an acute interstitiallunginvolvement in most of the older asymptomatic patients.Mortality rate progressively increasedaccording to clinical frailty and LUS score degree, resulting a reliable prognostic tool inboth symptomatic and asymptomatic patients.