Background: Effective early risk stratification in COVID-19 remains a critical challenge in emergency care, particularly due to the limitations of RT-PCR testing, including delayed processing and false negatives. There is an unmet need for imaging tools that are fast, reliable, and safe for repeated use in acute clinical settings. Methods: In this prospective, multicenter study, over 1000 patients hospitalized with suspected or confirmed COVID-19 were initially screened. A total of 555 patients with PCR-confirmed infection were ultimately included for analysis. All participants underwent low-dose chest CT (LDCT) at admission. Pulmonary involvement was assessed using the chest CT severity score (CTSS) based on a unified protocol. CTSS values were analyzed in relation to ICU admission, in-hospital mortality, demographic data, oxygen saturation, dyspnea scores, and laboratory markers (CRP, LDH, lymphocyte, and neutrophil counts). Imaging was interpreted by board-certified radiologists under harmonized reporting standards. Results: CTSS values ≥13 and ≥15 were significantly associated with ICU admission and in-hospital mortality, respectively (p < 0.01). Strong correlations were observed between the CTSS and CRP, LDH, and dyspnea scores, with negative correlations to oxygen saturation and lymphocyte count. The standardized LDCT protocol ensured consistent image quality and minimized radiation exposure. Conclusions: LDCT combined with the CTSS provides a robust, reproducible, and radiation-sparing method for emergency risk stratification in COVID-19. Its high clinical utility supports deployment in frontline triage systems and future AI-enhanced diagnostic workflows.

Background/Objectives: To assess quantitatively the correlation between the lung ultrasound severity scores (LUSSs) and chest CT severity scores (CTSSs) derived from low-dose computed tomography (LDCT) for evaluating pulmonary inflammation in COVID-19 patients. Methods: In this prospective observational study, from an initial cohort of 1000 patients, 555 adults (≥18 years) with confirmed COVID-19 were enrolled based on inclusion criteria. All underwent LDCT imaging, scored by the CTSS (0–25 points), quantifying involvement across five lung lobes. Lung ultrasound examinations using standardized semi-quantitative scales for the B-line (LUSS B) and consolidation (LUSS C) were performed in a subgroup of 170 patients; 110 had follow-up imaging after one week. Correlation analyses included Spearman’s and Pearson’s coefficients. Results: Significant positive correlations were found between the CTSS and both the LUSS B (r = 0.32; p < 0.001) and LUSS C (r = 0.24; p = 0.006), with the LUSS B showing a slightly stronger relationship. Each incremental increase in the LUSS B corresponded to an average increase of 0.18 CTSS points, whereas a one-point increase in the LUSS C corresponded to a 0.27-point CTSS increase. The mean influence of the LUSS on CTSS was 8.0%. Neither ultrasound score significantly predicted ICU admission or mortality (p > 0.05). Conclusion: Standardized lung ultrasound severity scores show a significant correlation with low-dose CT in assessing pulmonary involvement in COVID-19, particularly for the B-line artifacts. Lung ultrasound represents a valuable bedside tool, complementing—but not substituting—CT in predicting clinical severity. Integrating both imaging modalities may enable the acquisition of complementary bedside information and facilitate dynamic monitoring of disease progression.

Background/Objectives: Nutrition-related parameters may be associated with COVID-19 severity, but their relationships with complementary pulmonary imaging measures remain incompletely characterized. This study aimed to examine associations between selected nutrition-related parameters, pulmonary imaging severity, and clinical outcomes in hospitalized adults with COVID-19. Methods: This secondary exploratory analysis included 555 adults from a prospective multicenter cohort. Dietary intake assessed during the first week of hospitalization and derived from medical history, serum albumin and total protein concentrations, and selected bioimpedance parameters were examined in relation to computed tomography severity score (CTSS), lung ultrasonography (LUS) parameters, and selected clinical outcomes. Results: First-week hospital dietary intake was weakly inversely associated with CTSS (ρ = −0.110; p = 0.038), LUSSB (ρ = −0.274; p = 0.002), and LUSSBmax (ρ = −0.329; p < 0.001). History-derived dietary intake was associated with LUSSB (ρ = −0.253; p = 0.007) and LUSSBmax (ρ = −0.239; p = 0.011), but not with CTSS (ρ = −0.091; p = 0.120). Lower serum albumin was weakly associated with higher CTSS (ρ = −0.252; p = 0.008), whereas total protein was not (ρ = −0.199; p = 0.300). In unadjusted analyses, first-week hospital dietary intake, albumin, and total protein were associated with selected escalation-of-care outcomes, but not with in-hospital death. Nominal BIA–LUSSC associations were observed, but none remained statistically significant after correction for multiple testing. Conclusions: Selected nutrition-related parameters showed weak and non-uniform associations with pulmonary imaging severity in hospitalized adults with COVID-19. The findings do not establish independent prognostic relationships, and the exploratory bioimpedance results require confirmation in larger, appropriately designed studies.