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Background: Lung ultrasound is feasible for assessing lung injury caused by coronavirus disease 2019 (COVID-19). However, the prognostic meaning and time-line changes of lung injury assessed by lung ultrasound in COVID-19 hospitalised patients are unknown., Methods: Prospective cohort study designed to analyse prognostic value of lung ultrasound in COVID-19 patients by using a quantitative scale (lung ultrasound Zaragoza (LUZ)-score) during the first 72 h after admission. The primary end-point was in-hospital death and/or admission to the intensive care unit. Total length of hospital stay, increase of oxygen flow and escalation of medical treatment during the first 72 h were secondary end-points., Results: 130 patients were included in the final analysis; mean±sd age was 56.7±13.5 years. Median (interquartile range) time from the beginning of symptoms to admission was 6 (4-9) days. Lung injury assessed by LUZ-score did not differ during the first 72 h (21 (16-26) points at admission versus 20 (16-27) points at 72 h; p=0.183). In univariable logistic regression analysis, estimated arterial oxygen tension/inspiratory oxygen fraction ratio (PAFI) (hazard ratio 0.99, 95% CI 0.98-0.99; p=0.027) and LUZ-score >22 points (5.45, 1.42-20.90; p=0.013) were predictors for the primary end-point., Conclusions: LUZ-score is an easy, simple and fast point-of-care ultrasound tool to identify patients with severe lung injury due to COVID-19, upon admission. Baseline score is predictive of severity along the whole period of hospitalisation. The score facilitates early implementation or intensification of treatment for COVID-19 infection. LUZ-score may be combined with clinical variables (as estimated by PAFI) to further refine risk stratification., Competing Interests: Conflict of interest: J. Rubio-Gracia has nothing to disclose. Conflict of interest: I. Giménez-López has nothing to disclose. Conflict of interest: V. Garcés-Horna has nothing to disclose. Conflict of interest: D. López-Delgado has nothing to disclose. Conflict of interest: J.L. Sierra-Monzón has nothing to disclose. Conflict of interest: L. Martínez-Lostao has nothing to disclose. Conflict of interest: C. Josa-Laorden has nothing to disclose. Conflict of interest: F. Ruiz-Laiglesia has nothing to disclose. Conflict of interest: J.I. Pérez-Calvo has nothing to disclose. Conflict of interest: S. Crespo-Aznarez has nothing to disclose. Conflict of interest: J. García-Lafuente has nothing to disclose. Conflict of interest: N. Peña-Fresneda has nothing to disclose. Conflict of interest: B. Amores Arriaga has nothing to disclose. Conflict of interest: B. Gracia-Tello has nothing to disclose. Conflict of interest: M. Sánchez-Marteles has nothing to disclose., (Copyright ©The authors 2021.)