Background: Chest computed tomography (CT) is highly recommended for evaluating and monitoring suspected COVID-19 cases, serving as a standard diagnostic tool for pneumonia. It is effective in identifying typical radiographic features of COVID-19, such as ground-glass opacification, consolidation, and pleural effusion, which are commonly seen in affected patients. Compared to chest radiography, lung ultrasonography (LUS) offers higher diagnostic accuracy for interstitial lung disease and alveolar consolidation. LUS results align well with the clinical course, similar to high-resolution CT findings across various patient groups. Aim of the work: This study aimed to describe the results of the LUS examination and their association with the clinical course and outcome in hospitalized patients with COVID-19 infection, to assess risk, predict outcomes, and potentially replace chest CT with ultrasound as a more accessible and cost-effective method. Patients and methods: This was a comparative study involved 50 cases presenting with acute dyspnea (SpO₂ < 94% and/or shortness of breath) accompanied by a positive PCR test in a nasopharyngeal specimen, requiring admission to the COVID-19 isolation department of the Suez Canal University Hospital, during the period from March 2021 to September 2023.  Complete LUS was done on admission along with Chest CT and follow-up LUS was done on discharge, then follow-up by LUS & CT chest that is 24 h apart from LUS scan was done 6-8 weeks later. Results: This study showed that LUS score on admission was found to have a significant correlation with oxygen saturation on admission (negative correlation) and degree of pulmonary infiltration on pulmonary CT (positive correlation). It was found that the LUS score is an important predictor of ICU admission, prolonged hospital stays duration of more than 2 weeks, and incidence of post-COVID fibrosis 8 weeks after discharge. Over time, there was a statistically significant decrease in Lung ultrasound scores. Conclusions: Our study demonstrated that the LUS modality had a better overall diagnostic performance if added to CT scans in COVID-19 patients, particularly concerning consolidation and ground-glass opacities (GGO). It is recommended as an effective bedside tool for assessing severity and monitoring COVID-19 patients, especially for vulnerable groups like children, pregnant women, and critically ill patients who cannot be moved.