The Use of Acoustic Mapping to Improve Surveillance of Pediatric Patient with Residual COVID-19 Symptomology

Abstract

Objective: This study was designed to assess the severity of lung tissue changes due to COVID-19 in a pediatric cohort that still complained of post-COVID-19 symptoms. Materials and Methods: Parents and adolescents, 13 to 22 years old and have had a confirmatory positive polymerase chain reaction (+PCR) and/or rapid antigen test for COVID-19, consented to have a series of diagnostic tests to determine the level of lung tissue changes due to COVID-19. Sixteen adolescents completed the intake form and lung sonography. The lung sonogram was completed using the bedside lung ultrasound in emergency (BLUE) point method and a GE Logiq I laptop ultrasound system, as well as a linear 7.5-MHz or 3.0-MHz convex-array transducers. Thirteen adolescents completed a chest magnetic resonance imaging (MRI) examination on a 0.55T Siemens MAGNETOM Free.Max scanner. The examination included the heart and lungs of each participant and took about 90 minutes. A radiologist, sonographer, and computed tomography (CT) technologist reviewed and scored the images. Those positive lung sonogram scores were matched anatomically to the same slice within the chest MRI examination. Results: Based on the 13 participants, the acoustic mapping process demonstrated no diagnostic matches for positively scored sonograms at the pleural line or pulmonary parenchyma with the corresponding MRI image slices. There were diagnostic matches for negatively scored sonograms at the pleural line or pulmonary parenchyma with the corresponding MRI image slices. Conclusion: With lingering post-COVID-19 symptomology, this adolescent cohort demonstrated that acoustic mapping of their lung sonograms and chest MRI images had important combined diagnostic value. Lung sonography demonstrated diagnostic effectiveness for evaluating the periphery of the lung tissue, in this cohort but limited in viewing deeper structures. Conversely, MRI provided definitive views of the entire chest cavity and lung tissue, which is important for properly evaluating deeper pulmonary parenchyma.