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Purpose <p>To evaluate the correlation between the degree of pulmonary compromise, as assessed by lung ultrasound, and the activation of the coagulation cascade in patients hospitalized with COVID-19 pneumonia.</p> Methods <p>A prospective observational study was conducted on 47 adult patients with confirmed COVID-19 pneumonia. Each patient underwent a systematic 12-zone LUS exam to calculate a total Lung Ultrasound Score (LUS score). Arterial blood gas analysis was performed to calculate the arterial partial pressure of oxygen to fraction of inspired oxygen (<i>P</i>/<i>F</i>) ratio and the alveolar-arterial (A-a) oxygen gradient. Laboratory tests included serum D-dimer and C-reactive protein (CRP).</p> Results <p>The LUS score correlated positively and significantly with D-dimer values (<i>p</i> = 0.019; <i>ρ</i> = 0.342), CRP (<i>p</i> &lt; 0.001; <i>ρ</i> = 0.647), and the A-a gradient (<i>p</i> &lt; 0.001; <i>ρ</i> = 0.640). It also displayed a significant negative correlation with the P/F ratio (<i>p</i> &lt; 0.001; <i>ρ</i> = −0.614).</p> Conclusion <p>The degree of lung injury in COVID-19 pneumonia, as evaluated by LUS, correlates directly with elevated D-dimer levels, signifying increased coagulation activation. Lung ultrasound, as a bedside and noninvasive tool, could serve as a surrogate marker not only for pulmonary involvement but also for identifying patients at higher risk of thrombotic complications.</p>

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Lung ultrasound and coagulation activation in COVID-19 pneumonia

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月29日

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  • Alice Brighenti,
  • Livia Masi,
  • Daniela Agostinelli,
  • Nicola Venturoli,
  • Sofia Maria Bakken,
  • Fabrizio Giostra,
  • Andrea Boccatonda,
  • Carla Serra

摘要

Purpose

To evaluate the correlation between the degree of pulmonary compromise, as assessed by lung ultrasound, and the activation of the coagulation cascade in patients hospitalized with COVID-19 pneumonia.

Methods

A prospective observational study was conducted on 47 adult patients with confirmed COVID-19 pneumonia. Each patient underwent a systematic 12-zone LUS exam to calculate a total Lung Ultrasound Score (LUS score). Arterial blood gas analysis was performed to calculate the arterial partial pressure of oxygen to fraction of inspired oxygen (P/F) ratio and the alveolar-arterial (A-a) oxygen gradient. Laboratory tests included serum D-dimer and C-reactive protein (CRP).

Results

The LUS score correlated positively and significantly with D-dimer values (p = 0.019; ρ = 0.342), CRP (p < 0.001; ρ = 0.647), and the A-a gradient (p < 0.001; ρ = 0.640). It also displayed a significant negative correlation with the P/F ratio (p < 0.001; ρ = −0.614).

Conclusion

The degree of lung injury in COVID-19 pneumonia, as evaluated by LUS, correlates directly with elevated D-dimer levels, signifying increased coagulation activation. Lung ultrasound, as a bedside and noninvasive tool, could serve as a surrogate marker not only for pulmonary involvement but also for identifying patients at higher risk of thrombotic complications.