Prognosis Of COVID-19 Research Articles

Explainable artificial intelligence approaches for COVID-19 prognosis prediction using clinical markers

The COVID-19 influenza emerged and proved to be fatal, causing millions of deaths worldwide. Vaccines were eventually discovered, effectively preventing the severe symptoms caused by the disease. However, some of the population (elderly and patients with comorbidities) are still vulnerable to severe symptoms such as breathlessness and chest pain. Identifying these patients in advance is imperative to prevent a bad prognosis. Hence, machine learning and deep learning algorithms have been used for early COVID-19 severity prediction using clinical and laboratory markers. The COVID-19 data was collected from two Manipal hospitals after obtaining ethical clearance. Multiple nature-inspired feature selection algorithms are used to choose the most crucial markers. A maximum testing accuracy of 95% was achieved by the classifiers. The predictions obtained by the classifiers have been demystified using five explainable artificial intelligence techniques (XAI). According to XAI, the most important markers are c-reactive protein, basophils, lymphocytes, albumin, D-Dimer and neutrophils. The models could be deployed in various healthcare facilities to predict COVID-19 severity in advance so that appropriate treatments could be provided to mitigate a severe prognosis. The computer aided diagnostic method can also aid the healthcare professionals and ease the burden on already suffering healthcare infrastructure.

The Impact of SARS-CoV-2 on the Coagulation Profile of Pregnant Women

A prospective study was conducted in the Clinic Hospital of Obstetrics and Gynecology "Dr. I.A. Sbârcea" Brașov, which included hospitalized pregnant women diagnosed with COVID-19 from January 1, 2020, to March 8, 2022. The study aimed to evaluate the influence of SARS-CoV-2 on the coagulation status, the blood levels of coagulation parameters, and the presence of disseminated intravascular coagulation in pregnant women with COVID-19. To analyze the coagulation status of the pregnant women we used the following parameters: Fibrinogen level, INR, D-dimer test, and the presence of disseminated intravascular coagulation. Following the study, we concluded that the occurrence of coagulation disorders in pregnant women is related to the severity of the SARS-CoV 2. LMWH administration generally improved the prognosis of pregnancy-associated COVID-19 and mostly prevented the occurrence of severe thromboembolic complications such as disseminated intravascular coagulation or deep venous thrombosis.

The Impact of Secondary Catheter-Related Bloodstream Infection on the Course of COVID-19 Infection

Abstract Background Secondary bacterial infections can worsen the prognosis for COVID-19, especially in patients with severe infections. Thus, we aim to investigate the effect of secondary catheter-related bloodstream infections on the course of COVID-19 infection. Material and Methods This is a retrospective, nested case-control study and included 236 confirmed COVID-19 infection hospitalized patients, divided into 2 groups (COVID-19, n = 64; non–COVID-19, n = 172) according to SARS-CoV-2 RT-PCR results. Results The age, sex, and prevalence of chronic diseases were similar in both groups. Klebsiella pneumoniae (31.2%) and Acinetobacter baumannii (21.9%) were the predominant microorganisms in the COVID-19 group. Only A. baumannii was statistically higher in the COVID-19 group (P = 0.046). There were no significant differences in terms of resistance profiles. The 30-day mortality was significantly higher in the COVID-19 group (56.3%) than in the non–COVID-19 group (38.4%) (P = 0.014). There was no significant difference in the length of stay between the 2 groups. The multiple logistic regression analysis of risk factors for 30-day mortality revealed that COVID-19 positivity (odds ratio [OR], 2.167; 95% confidence interval [CI], 1.056–4.446; P = 0.035), infection with extensively drug-resistant bacteria (OR, 2.949; 95% CI, 1.311–6.636; P = 0.009), and infection with pandrug-resistant bacteria (OR, 3.601; 95% CI, 1.213–10.689; P = 0.021) were independent risk factors for 30-day mortality. Conclusion As a conclusion, this study demonstrated that COVID-19 positivity is an independent risk factor for 30-day mortality of secondary catheter-related bloodstream infections. Gram-negative bacteria were the predominant microorganisms, with A. baumannii being statistically higher in the COVID-19 group compared with the non–COVID-19 group. However, there were no statistically significant differences in terms of the resistance profile of microorganisms.

Characteristics and prognosis of patients with COVID-19 and hematological diseases in Japan: a cross-sectional study

The Japanese Society of Hematology performed an observational cross-sectional study to clarify the morbidity, prognosis, and prognostic factors in patients with COVID-19 with hematological diseases (HDs) in Japan. The study included patients with HDs who enrolled in our epidemiological survey and had a COVID-19 diagnosis and a verified outcome of up to 2 months. The primary endpoints were characteristics and short-term prognosis of COVID-19 in patients with HDs. A total of 367 patients from 68 institutes were enrolled over 1 year, and the collected data were analyzed. The median follow-up among survivors was 73 days (range, 1–639 days). The 60-day overall survival (OS) rate was 86.6%. In the multivariate analysis, albumin ≤ 3.3 g/dL and a need for oxygen were independently associated with inferior 60-day OS rates (hazard ratio [HR] 4.026, 95% confidence interval (CI) 1.954–8.294 and HR 14.55, 95% CI 3.378–62.64, respectively), whereas 60-day survival was significantly greater in patients with benign rather than malignant disease (HR 0.095, 95% CI 0.012–0.750). Together, these data suggest that intensive treatment may be necessary for patients with COVID-19 with malignant HDs who have low albumin levels and require oxygen at the time of diagnosis.

PROGNOSIS IN COVID-19

PROGNOSIS IN COVID-19

Applications of Mass Spectrometry in the Characterization, Screening, Diagnosis, and Prognosis of COVID-19.

Mass spectrometry (MS) is a powerful analytical technique that plays a central role in modern protein analysis and the study of proteostasis. In the field of advanced molecular technologies, MS-based proteomics has become a cornerstone that is making a significant impact in the post-genomic era and as precision medicine moves from the research laboratory to clinical practice. The global dissemination of COVID-19 has spurred collective efforts to develop effective diagnostics, vaccines, and therapeutic interventions. This chapter highlights how MS seamlessly integrates with established methods such as RT-PCR and ELISA to improve viral identification and disease progression assessment. In particular, matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS) takes the center stage, unraveling intricate details of SARS-CoV-2 proteins, revealing modifications such as glycosylation, and providing insights critical to formulating therapies and assessing prognosis. However, high-throughput analysis of MALDI data presents challenges in manual interpretation, which has driven the development of programmatic pipelines and specialized packages such as MALDIquant. As we move forward, it becomes clear that integrating proteomic data with various omic findings is an effective strategy to gain a comprehensive understanding of the intricate biology of COVID-19 and ultimately develop targeted therapeutic paradigms.

D-dimer and HbA1c levels findings in COVID-19 Iraqi patients.

On March 11, 2020, the World Health Organization (WHO) declared a new coronavirus infection caused by the SARS-CoV-2 virus as a pandemic, making it the 11th pandemic of the 20th and 21st centuries. This study investigated the clinical and laboratory results (D-dimer, conventional coagulation, and HbA1c biomarker concentrations) of 150 patients (75 male and 75 female) with confirmed COVID-19 pneumonia and 50 controls (25 male and 25 female). For disease diagnosis, all COVID-19 patients were given a Real-Time Reverse Transcription Polymerase Chain Reaction Assay (RT-PCR). The findings revealed that D-dimer and HbA1c levels in COVID-19 patients were significantly higher (P 0.001) at the time of admission; In COVID-19 patients, there was also a strong correlation between D-dimer levels and HbA1c levels (P 0.001). In conclusion, COVID-19 patients are more likely to have a poor prognosis if their D-dimer and HbA1c levels remain uncontrolled over a lengthy period. To lower the likelihood of a bad prognosis in COVID-19, patients with higher levels of D-dimer and HbA1c should be continuously monitored.

Several laboratory variables indicate severity and prognosis of COVID-19.

While several laboratory variables have been used to assess COVID-19 disease, to our knowledge, no attempt has previously been made to compare differences across different patient groups. We attempted to evaluate the relationship between laboratory variables and severity of the disease as well as on prognosis. We searched BioLINCC database and identified three studies which had separately included outpatients, inpatients, and ICU patients. For this re-analysis, we extracted data on general demography, laboratory variables and outcome. In total, 2454 participants (496 outpatients [Study 1], 478 inpatients [Study 2], and 1480 ICU patients [Study 3]) were included in the analysis. We found three laboratory variables (i.e., creatinine, aspartate transferase, and albumin) were not only prognostic factors for outcome of inpatients with COVID-19, but also reflected disease severity as they were significantly different between inpatients and ICU patients. These three laboratory variables are an indication of kidney function, liver function, and nutritional status. For patients with COVID-19, in addition to monitoring infectious disease indicators, we need to pay attention to liver function, renal function, and take timely measures to correct them to improve prognosis.

Nutritional status and its relationship with COVID-19 prognosis in hemodialysis patients.

Introduction: among the groups more affected by the COVID-19 pandemic were patients undergoing chronic hemodialysis (HD) treatment due to their comorbidities, advanced age, impaired innate and adaptive immune function, and increased nutritional risk due to their underlying inflammatory state. All of these factors contribute to a higher risk of severe complications and worse outcomes compared to the general population when infected with SARS-CoV-2. Objective: the objective of this study was to describe the nutritional characteristics of and their potential association with the prognosis of COVID-19 in patients undergoing chronic HD treatment. Method: a descriptive, retrospective, observational design. All cases of COVID-19 in patients undergoing chronic treatment at the Hemodialysis Unit of Hospital de Manises, Valencia, Spain, from the start of the pandemic to before vaccination were included. Results: for that, 189 patients were studied, who received chronic HD treatment in the hospital unit, 22 patients were diagnosed with COVID-19 (12 %) in that period. The mean age was 71 years, 10 were women, the Charlson index was 6.59 points, diabetes mellitus 10, vintage HD 51.6 months, 2 patients had previously received a currently non-functioning kidney transplant, 16 had arteriovenous fistula as vascular access, and 6 had central vascular access. The mean dialysis session time was 220.14 minutes and the initial value of the single dose of the Kt/V pool was 1.7. 16 patients had body composition measurement, a strong association (p < 0.05) was identified between mortality and BMI, as well as mortality and FTI. Furthermore, the differences between deceased and surviving groups in the serum levels of various variables related to nutritional status were analyzed, finding significant differences with p < 0.05 in the value of triglycerides and ferritin. Conclusions: higher body mass index and higher body fat content, along with lower baseline levels of triglycerides and ferritin, were significantly associated with higher COVID-19 mortality in patients on chronic hemodialysis. These findings suggest that the initial nutritional status of these patients can significantly influence the prognosis of SARS-CoV-2 infection.

IFITM3 rs12252 polymorphism association with COVID-19 severity and mortality in a Brazilian sample: an update and a meta-analysis.

This study investigated the association between the IFITM3 rs12252 polymorphism and the severity and mortality of COVID-19 in hospitalized Brazilian patients. A total of 102 COVID-19 patients were included, and the outcomes of interest were defined as death and the need for mechanical ventilation. Genotypes were assessed using Taqman probes. No significant associations were found between the rs12252 polymorphism and COVID-19 outcomes in the original sample, both for death and the need for mechanical ventilation. A meta-analysis, incorporating previous studies that used death as a severity indicator, revealed no association in the allelic and C-recessive models. However, due to the rarity of the T allele and its absence in the sample, further replication studies in larger and more diverse populations are needed to clarify the role of rs12252 in COVID-19 prognosis.

Амбулаторная гиполипидемическая терапия у пациентов с очень высоким сердечно-сосудистым риском в период пандемии COVID-19

Background: despite a broad armamentarium of effective lipid-lowering agents, which is being replenished by new classes of drugs, the achievement of target lipid metabolism (LM) parameters in patients at high and very high cardiovascular risk (CVR) remains extremely urgent. The accumulation of data on SARS-CoV-2 during the pandemic contributed to a detailed study of the pathogenetic mechanisms of COVID-19. Among these mechanisms, endothelial dysfunction and atherosclerosis are the most important. Therefore, there is concern about LM in patients with cardiovascular disorders who have experienced coronavirus disease 2019, when adequate lipid-lowering therapy (LLT) determines further prognosis and survival Aim: to evaluate outpatient LLT in patients with very high CVR during the COVID-19 pandemic. Patients and Methods: 114 patients with cardiovascular disorders and very high CVR underwent a voluntary direct clinical interview about LLT and laboratory tests for LM during the COVID-19 pandemic. Results: low awareness of atherosclerosis and the importance of LLT was reported (only 26.32% of patients could be described as fully aware). Most patients (48.24%) only learn about their LM status after admission to hospital. 41.23% monitor their lipid profile on an outpatient basis every 3–6 months, but only 25.44% were able to specify their serum cholesterol level. Study participants received statins as LLT during the COVID-19 pandemic, but 48.94% received statins at inappropriately low doses. COVID-19 morbidity affected adherence to LLT, i.e. 38.59% discontinued lipid-lowering therapy during COVID-19 and 17.54% never restarted it after recovery. Evaluation of laboratory tests for LM in patients with very high CVR showed that only 6.26% achieved target values. Conclusion: low awareness, unhealthy lifestyle and inadequate drug therapy during the COVID-19 pandemic worsen LM and prognosis in patients with very high CVR in terms of adverse cardiovascular events. KEYWORDS: lipid-lowering therapy, dyslipidemia, lipid metabolism, cardiovascular risk, COVID-19 pandemic, adherence. FOR CITATION: Sergeeva V.A., Lipatova T.E. Outpatient lipid-lowering therapy in patients at very high cardiovascular risk during the COVID-19 pandemic. Russian Medical Inquiry. 2024;8(1):9–15 (in Russ.). DOI: 10.32364/2587-6821-2024-8-1-2.

Accurate COVID-19 detection using full blood count data and machine learning

COVID-19 has spread rapidly worldwide in the past three years, triggering partial and full lockdowns globally. The successful control of the COVID-19 pandemic on a global scale depended heavily upon the accurate detection of COVID-19. However, the main diagnostic tests for COVID-19 have some significant limitations, e.g. the major nucleic acid (RT-PCR) tests while having a high sensitivity are time-consuming and require expensive equipment with the shortage of test kits in many countries. Antigen lateral flow tests have a lower sensitivity and they cannot be used during the early pandemic as well as usually more expensive than the full or complete blood count test used in this paper which can be potentially performed using a finger blood sample. The last decade has seen rapid growth of AI, particularly deep learning, which has found wide applications in medical image analysis, with results comparable to and even surpassing human expert performance. There have been several machine learning models reported for COVID-19 diagnostics or prognosis predictions, most of them based on CT and X-ray images. In this paper we have applied traditional machine learning and convolutional neural networks (CNNs) based deep learning to the blood test data obtained from hematology analyzers and demonstrated that the AI models can be used to detect COVID-19 with a high degree of accuracy (&gt;97%). The performance of different classifiers will be compared and discussed. The work should have potential applications in current COVID-19 and future pandemics.

Coagulation parameters and prognosis analysis in COVID-19 patients

Aims: There are many factors that affect morbidity and mortality in COVID-19. Coagulopathy is thought to be one of the important mechanisms in COVID-19 mortality. In this study, it was aimed to investigate coagulation factors and their relationship with prognosis in COVID-19. Methods: Patients diagnosed with COVID-19 were retrospectively reviewed in our hospital. The patients' demographic data, laboratory data on admission to the hospital, intensive care admissions, and surveillance were recorded. Patients were divided into two groups; Group 1 is non-critical patients followed up in the clinic, Group 2 is critical patients who need treatment in the intensive care unit. Results: 403 patients followed up for COVID-19 were analyzed. It was determined that the average age of the patients in Group 1 was statistically significantly lower than those in Group 2. (1: 45.28 ± 15.31 vs. 2: 60.15 ± 15.72, respectively, p &lt;0.001). It was observed that the rates of HT, DM, CHD, and COPD in Group 2 were statistically significantly higher than Group 1 (p &lt;0.05). While APTT values were similar in both groups, D-Dimer values were significantly higher in Group 2. As QSOFA, SIC, DIC, and coagulation marker scores increased, the percentage of patients with death increased significantly (p &lt;0.05). Age, HT, COPD, PT, and high fibrinogen levels were found to increase the mortality risk rates statistically (p &lt;0.05). Conclusion: It was determined that the most important factors determining mortality in COVID-19 are COPD and HT. APTT and D-dimer values were not found to be a prognostic factor in terms of mortality. However, PT, fibrinogen, and age are poor prognostic factors and can be used to predict mortality requiring intensive care.

Human serum albumin binds spike protein and protects cells from SARS-CoV-2 infection by modulating the RAS pathway

Since the start of the pandemic, scientists have directed their research towards identifying COVID-19 risk factors and predictive elements. Numerous clinical studies have established a strong connection between hypoalbuminemia and an unfavorable prognosis for COVID-19. Here, we aim to explore the impact of human serum albumin (HSA) on SARS-CoV-2 infection. Our findings indicate that HSA plays a role in reducing the replication rate of SARS-CoV-2 in Vero E6 cells. This protective effect is due to HSA ability to bind to the S1 domain of the spike protein, effectively competing with ACE2. Moreover, we show that the protective role of HSA is dependent also on its ability to activate the protective axis within the RAS system pathway, which is responsible for inducing vasodilation and promoting anti-inflammatory, anti-fibrotic, and anti-apoptotic responses. In summary, the data presented in this study support the idea that reduced levels of circulating HSA in hypoalbuminemic patients may heighten their susceptibility to SARS-CoV-2 infection, as the spike protein is unhindered in its ability to bind to ACE2 and penetrate human cells. Besides, hypoalbuminemia exacerbates the imbalance of the RAS pathway towards the classical “detrimental” axis. This could potentially contribute to the increased severity and elevated mortality rate observed in individuals with low levels of circulating albumin.

Machine Learning-Based Prediction of COVID-19 Prognosis Using Clinical and Hematologic Data

Machine Learning-Based Prediction of COVID-19 Prognosis Using Clinical and Hematologic Data

SSRIs in the course of COVID-19 pneumonia: Evidence of effectiveness of antidepressants on acute inflammation. Aretrospective study.

Relationships between inflammation and mood have been observed in terms of pro-inflammatory effects induced by depressive conditions and, in parallel, by an antidepressant-induced favorable effect on the recovery of inflammatory states. Selective serotonin reuptake inhibitor (SSRI) drugs were hypothesized to improve the prognosis of COVID-19 pneumonia, a typical acute inflammation, in terms of decreased mortality rate and pro-inflammatory cytokine serum levels. The medical records of COVID-19 pneumonia inpatients at Careggi University Hospital (Florence) were analyzed for prognosis and Interleukin 6 (IL-6) after admission for over a period of 22months. Medical records of patients treated at admission and not discontinued until discharge with an SSRI or with vortioxetine were identified. Two groups, one treated with antidepressants, the other not treated, were evaluated according to the mentioned parameters. Multiple linear regression and logistic regression were performed. The entire sample composed of 1236 records (recovered patients 77.1%, deceased patients 22.9%). The treated group (n=107) had a better prognosis than the untreated group in spite of age and comorbidity both being greater than in the untreated group. Correspondingly, IL-6 levels in the treated group were significantly lower (p<0.01) than the levels in the untreated group, in every comparison. Outcomes of this study support the hypothesis of the favorable influence of some antidepressants on the prognosis of COVID-19, possibly mediated by IL-6 modulation. Reduction in acute inflammation induced by the action of antidepressants was confirmed.

Variation in presepsin and thrombomodulin levels for predicting COVID-19 mortality

Coronavirus disease (COVID-19) has caused extensive mortality globally; therefore, biomarkers predicting the severity and prognosis of COVID-19 are essential. This study aimed to evaluate the application of presepsin (P-SEP) and thrombomodulin (TM), which are biomarkers of sepsis and endothelial dysfunction, respectively, in the prognosis of COVID-19. Serum P-SEP and TM levels from COVID-19 patients (n = 183) were measured. Disease severity was classified as mild, moderate I, moderate II, or severe based on hemoglobin oxygen saturation and the history of intensive care unit transfer or use of ventilation at admission. Patients in the severe group were further divided into survivors and non-survivors. P-SEP and TM levels were significantly higher in the severe group than those in the mild group, even after adjusting for creatinine values. In addition, TM levels were significantly higher in non-survivors than in survivors. Changes in the P-SEP levels at two time points with an interval of 4.1 ± 2.2 days were significantly different between the survivors and non-survivors. In conclusion, TM and continuous P-SEP measurements may be useful for predicting mortality in patients with COVID-19. Moreover, our data indicate that P-SEP and TM values after creatinine adjustment could be independent predictive markers, apart from renal function.

Impact of IL-6 rs1800795 and IL-17A rs2275913 gene polymorphisms on the COVID-19 prognosis and susceptibility in a sample of Iranian patients

BackgroundFrom asymptomatic to acute and life-threatening pulmonary infection, the clinical manifestations of COVID-19 are highly variable. Interleukin (IL)-6 and IL-17A are key drivers of hyper inflammation status in COVID-19, and their elevated levels are hallmarks of the infection progression. To explore whether prognosis and susceptibility to COVID-19 are linked to IL-6 rs1800795 and IL-17A rs2275913, these single-nucleotide polymorphisms (SNPs) were assessed in a sample of Iranian COVID-19 patients. MethodsThis study enrolled two hundred and eighty COVID-19 patients (140 non-severe and 140 severe). Genotyping for IL-6 rs1800795 and IL-17A rs2275913 was performed using tetra primer-amplification refractory mutation system-polymerase chain reaction (tetra-ARMS-PCR). IL-6 and IL-17A circulating levels were measured using enzyme-linked immunosorbent assay (ELISA). Also, mortality predictors of COVID-19 were investigated. ResultsThe rs1800795 GG genotype (78/140 (55.7 %)) and G allele (205/280 (73.2 %)) were significantly associated with a positive risk of COVID-19 severe infection (OR = 2.19, 95 %CI: 1.35–3.54, P =.006 and OR = 1.79, 95 %CI: 1.25–2.56, P <.001, respectively). Also, rs1800795 GG genotype was significantly linked to disease mortality (OR = 1.95, 95 %CI: 1.06–3.61, P =.04). The rs2275913 GA genotype was protective against severe COVID-19 (OR = 0.5, 95 %CI: 0.31––0.80, P =.012). However, the present study did not reveal any significant link between rs2275913 genotypes with disease mortality. INR ≥ 1.2 (OR = 2.19, 95 %CI: 1.61–3.78, P =.007), D-dimer ≥ 565.5 ng/mL (OR = 3.12, 95 %CI: 1.27–5.68, P =.019), respiratory rate ≥ 29 (OR = 1.19, 95 %CI: 1.12–1.28, P =.001), IL-6 serum concentration ≥ 28.5 pg/mL (OR = 1.97, 95 %CI: 1.942–2.06, P =.013), and IL-6 rs1800795 GG genotype (OR = 1.95, 95 %CI: 1.06–3.61, P =.04) were predictive of COVID-19 mortality. ConclusionThe rs1800795 GG genotype and G allele were associated with disease severity, and INR, D-dimer, respiratory rate, IL-6 serum concentration, and IL-6 rs1800795 GG genotype were predictive of COVID-19 mortality.

Visceral fat area measured by electrical bioimpedance on the prognosis of COVID-19

Visceral fat area measured by electrical bioimpedance on the prognosis of COVID-19

Clinical Manifestations Laboratory Tests Abdominal Ultrasonic Findings and In-hospital Prognosis of COVID-19 in 185 Pediatric Cases in a Tertiary Center.

Despite the COVID-19 pandemic, there is little information about the different clinical aspects of COVID-19 in children. In this study, we assessed the clinical manifestations, outcome, ultrasound, and laboratory findings of pediatric COVID-19. This retrospective study was conducted on 185 children with definitive diagnosis of COVID-19 between 2021 and 2022. The patients' information was retrieved from hospital records. The average age of the patients was 5.18 ± 4.55 years, and 61.1% were male. The most frequent clinical manifestation was fever (81.1%) followed by cough (31.9%), vomiting (20.0%), and diarrhea (20.0%). Mesenteric lymphadenitis was common on ultrasound and found in 60% of cases. In-hospital death was identified in 3.8% of cases. The mean length of hospital stay was 8.5 days. Mandating intensive care unit (ICU) stay was found in 19.5% and 5.9% of cases were intubated. Acute respiratory distress syndrome (ARDS), lower arterial oxygen saturation, higher white blood cell (WBC) count, and higher C-reactive protein (CRP) were the main determinants of death. Lower age, respiratory distress, early onset of clinical manifestations, lower arterial oxygen saturation, lower serum hemoglobin (Hb) level, and higher CRP level could predict requiring ICU admission. We recommend close monitoring on CRP, serum Hb level, WBC count, and arterial level of oxygenation as clinical indicators for potential progression to critical illness and severe disease. Mesenteric lymphadenitis is a common sonographic finding in pediatric COVID-19 which can cause abdominal pain. Ultrasound is helpful to avoid unnecessary surgical interventions in COVID-19.