Background: Computed tomography (CT) could be considered the gold standard for diagnosis of Corona Virus Disease-19 (COVID-19) but has some drawbacks such as resource allocation, radiation exposure, and the need for specialized facilities. This work aimed to confirm the role of Chest ultrasound as bed-side accessible tool in the follow up of COVID-19 patients during their hospital stay for better management and to improve the outcome.

Methods: This cohort study included 60 patients who got admitted to Zagazig Chest Hospital with confirmed PCR tests for COVID-19. Routine laboratory investigations, CT imaging and Chest Ultrasound (CUS) were done to all patients at time of admission and periodically during follow up period during hospitalization.

Results: Ultrasound findings showed a progressive decrease in consolidation with airbronchogram and B-lines from Day 1 to Day 21, while fluid bronchograms increased on Day 14 and slightly decreased by Day 21. Fragmented pleural lines increased on Day 14 and decreased by Day 21. The ultrasound severity index (USI) indicated predominantly severe lung involvement on Days 1 and 14, with a shift toward moderate findings by Day 21 as some patients recovered. Comparing USI with CT severity score (CTSS), severe USI (CTSS 16–20) showed high sensitivity (90%) and specificity (85%) with (89%) accuray on Day 1, while moderate and mild USI were associated with lower CTSS and a gradual reduction in severity scores by Day 21.

Conclusion: High accuracy of Chest Ultrasound indicates the effectiveness of U/S in monitoring COVID-19 progression.