The Study of Lung Ultrasound, Chest CT and Chest X-ray in Children with COVID-19 Hospitalized in Mofid Children's Hospital During a Six-Month Period

Abstract

Background: Coronavirus disease (COVID-19) is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The primary diagnostic tool for pediatric COVID-19 patients is polymerase chain reaction (PCR). Chest imaging findings in pediatric COVID-19 cases are often normal or mild. The correlation of lung ultrasound (LUS) with chest computed tomography (CT) and chest X-ray (CXR) in pediatric COVID-19 patients has not been extensively studied. Objectives: This study aimed to assess the correlation of LUS with chest CT and CXR in detecting COVID-19 pneumonia in children. Methods: This single-center cross-sectional study included patients under 18 years of age diagnosed with COVID-19 by PCR or by abnormal chest CT findings suggestive of COVID-19, admitted to Mofid Pediatric Hospital between December 2021 and August 2022. All patients underwent LUS. Approximately half of the patients also had a chest CT, and CXR was performed on 35 patients. Lung ultrasound and CT scores were calculated, and the correlation between these scores was evaluated. The correlation between LUS and CXR was also analyzed. Results: Sixty patients were included, of whom 21 were female, with a mean age of 4.9 ± 4.0 years. A significant correlation was observed between LUS and CT scores (correlation coefficient = 0.467, P = 0.011). Lesion distribution was similar between LUS and CT. However, no significant correlation was found between LUS scores and CXR findings (P = 0.392). Sixteen out of 19 patients with normal CXRs had LUS scores ≤ 4. Notably, three patients with normal CXRs had LUS scores of 8, 14, and 14. Conclusions: Lung ultrasound was more sensitive than CXR and demonstrated a significant correlation with CT. Lung ultrasound may serve as a safe alternative to CT for detecting COVID-19 pneumonia in pediatric patients.