Abstract
BackgroundThere has been limited data regarding the usefulness of lung ultrasound (US) in children with COVID-19.ObjectiveTo describe lung US imaging findings and aeration score of 34 children with COVID-19.MethodsThis study included 0–16-year-old patients with confirmed COVID-19, who were admitted between April 19 and June 18, 2020 in two hospitals in the city of Sao Paulo, Brazil. Lung US was performed as part of the routine evaluation by a skilled Pediatric Emergency physician. Clinical and laboratory data were collected and severity classifications were done according to an available clinical definition. The lung US findings were described for each lung field and a validated ultrasound lung aeration score was calculated. Data obtained was correlated with clinical information and other imaging modalities available for each case.ResultsThirty-four confirmed COVID-19 patients had a lung US performed during this period. Eighteen (18/34) had abnormalities on the lung US, but eight of them (8/18) had a normal chest radiograph. Ultrasound lung aeration score medians for severe/critical, moderate, and mild disease were 17.5 (2–30), 4 (range 0–14), 0 (range 0–15), respectively (p = 0.001). Twelve patients (12/34) also had a chest computed tomography (CT) performed; both the findings and topography of lung compromise on the CT were consistent with the information obtained by lung US.ConclusionPoint-of-care lung US may have a key role in assessing lung injury in children with COVID-19.
Highlights
Since its initial identification in December 2019, the coronavirus disease 2019 (COVID-19) has infected millions of people and has led to thousands of deaths worldwide as of July 2020 [1]
Point-of-care lung US may have a key role in assessing lung injury in children with COVID-19
A confirmed case of COVID-19 was defined by a positive result on the RT-PCR assay of a specimen collected from a nasopharyngeal swab or a positive IgG and IgM antibodies specific for SARS-Cov-2, titled using the viral nucleoprotein as the antigen in an ELISA test in-house
Summary
Since its initial identification in December 2019, the coronavirus disease 2019 (COVID-19) has infected millions of people and has led to thousands of deaths worldwide as of July 2020 [1]. Reports from adults suggest that this disease can have a more severe course in as many as 18.5% of infected people, in children it seems to be milder with an estimated incidence of severe cases of 4–6% and a lower case-fatality ratio reported [1,2,3]. Previous studies regarding the clinical aspects of COVID-19 in children described symptoms that followed a similar pattern as in adults [3], but recent reports have identified an emerging novel spectrum of the disease in children, which includes a multisystem inflammatory condition with overlapping features of toxic shock syndrome [4]. There has been limited data regarding the usefulness of lung ultrasound (US) in children with COVID-19
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