Purpose: This study aimed to assess capability of lung ultrasound to distinguish different pulmonary patterns of COVID-19 and compare it to chest CT. Materials and Methods: This is a prospective randomized controlled study carried upon sixty-five patients from beginning of November 2021 to the end of October 2022 admitted to Isolation Hospital for COVID -19 patients and in isolation ward in Tanta Emergency Department. Results: Lung Ultrasound can significantly predict mild to moderate COVID-19 pneumonia (P=0.003 and AUC=0.704) with 98.04% sensitivity, 42.86 %specificity, 86.2% PPV and 85.7% NPV and severe COVID-19 pneumonia (P=<0.001 and AUC=0.885) with 92.00% sensitivity, 85.00% specificity, 79.3% PPV and 94.4% NPV. By dividing the patients into two groups according to Computed Tomography Severity Score and Lung Ultrasound Scoring System, there was a substantial agreement between CTSS and LUSS (P value<0.001, Kappa = 0.632). Conclusions: Lung ultrasound can substitute CT chest in predicting, screening and diagnosis of COVID-19 pneumonia.