Anna Maria Musolino1, Maria Chiara Supino1, Danilo Buonsenso2, Raffaele Edo Papa3, Sara Chiurchiù4, Andrea Magistrelli5, Maria Antonietta Barbieri6, Massimiliano Raponi7, Patrizia D'Argenio4, Alberto Villani8, Paolo Tomà5. 1. Pediatric Emergency, Department of Emergency and General Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy. 2. Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. 3. Pediatric Unit, Department of Emergency and General Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Palidoro, Italy. 4. Division of Immunology and Infectious Disease, Academic Department of Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy. 5. Department of Imaging, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy. 6. Pediatric Emergency, Department of Emergency and General Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Palidoro, Italy. 7. Medical Direction, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy. 8. Department of Emergency and General Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Abstract
BACKGROUND: The coronavirus disease 2019 (COVID-19) has caused a new global pandemic and is responsible for millions of infections and thousands of deaths in the world. The lung ultrasound (LUS) is a noninvasive and easily repeatable tool and can be carried out by the pediatrician at the bedside of children with a consequent reduction in the risk of transmission of the virus. OBJECTIVE: We hypothesized that ultrasound findings in these patients would (1) be associated with their disease severity and (2) change over time in alignment with clinical outcome. METHODS: The study was made in the emergency department (ED) in a tertiary level pediatric hospital. All patients with swab-confirmed COVID-19 infection were subjected to a LUS within 6 h from admission and after 96 h. RESULTS: Among a total of 30 children, 18 (60%) were males, 4 reported exertional dyspnea, and only 1 chest pain. The mean oxygen saturation was 98.8 ± 1.0% in ambient air in the ED and no patient needed oxygen therapy during hospitalization. Children with moderate disease presented more B line (p = .03). After 96 h, we had observed ultrasound abnormality only in 20% of the children. We found a statistically significant reduction in pleural irregularities (30% vs. 16.7; p = .001) and in B lines (50% vs. 20%; p = .008). CONCLUSIONS: The LUS is a useful, feasible, and safe tool for the clinician to complement the clinical evaluation and to monitor the evolution of lung disease in children with COVID-19.
BACKGROUND: The coronavirus disease 2019 (COVID-19) has caused a new global pandemic and is responsible for millions of infections and thousands of deaths in the world. The lung ultrasound (LUS) is a noninvasive and easily repeatable tool and can be carried out by the pediatrician at the bedside of children with a consequent reduction in the risk of transmission of the virus. OBJECTIVE: We hypothesized that ultrasound findings in these patients would (1) be associated with their disease severity and (2) change over time in alignment with clinical outcome. METHODS: The study was made in the emergency department (ED) in a tertiary level pediatric hospital. All patients with swab-confirmed COVID-19infection were subjected to a LUS within 6 h from admission and after 96 h. RESULTS: Among a total of 30 children, 18 (60%) were males, 4 reported exertional dyspnea, and only 1 chest pain. The mean oxygen saturation was 98.8 ± 1.0% in ambient air in the ED and no patient needed oxygen therapy during hospitalization. Children with moderate disease presented more B line (p = .03). After 96 h, we had observed ultrasound abnormality only in 20% of the children. We found a statistically significant reduction in pleural irregularities (30% vs. 16.7; p = .001) and in B lines (50% vs. 20%; p = .008). CONCLUSIONS: The LUS is a useful, feasible, and safe tool for the clinician to complement the clinical evaluation and to monitor the evolution of lung disease in children with COVID-19.
Authors: Ivan Fiorito; Giulia Gori; Tiziano Perrone; Amelia Mascolo; Silvia Caimmi; Ilaria Palumbo; Annalisa De Silvestri; Mariangela Delliponti; Antonio Di Sabatino; Gian Luigi Marseglia Journal: Front Pediatr Date: 2022-02-28 Impact factor: 3.418