The lung ultrasound in children with SARS-COV 2 infection: a national
multicenter prospective study
Abstract
Covid-19 causedhospitalizations, severe disease and deaths in any age,
including in the youngest children. The aim of this multicenter national
study is to characterize the clinical and the prognostic role of lung
ultrasound (LUS) in children with Covid-19. We enrolled children between
1 month and 18 years of age diagnosed with SARS-CoV2 infection and
whounderwenta lung ultrasound within 6 hours from firstmedical
evaluation. A total of 213 children were enrolled, 51.6%were male,
median age was2 years and 5 months (IQR 4mm- 11 yearsand4 months).One
hundred and fortyeight (69.4%) children were admitted in hospital, 9
(6.1%) in pediatric intensive care unit.We found an inverse correlation
between the LUS score and the oxygen saturationatthe clinical evaluation
(r = −0.16; p = 0.019). Moreover, LUS scores were significantly higher
in patients requiring oxygen supplementation (8 (IQR 3 - 19) vs 2 (IQR 0
- 4); p= 0.001). Among LUS pathological findings, irregular pleural
line, sub-pleural consolidations and pleural effusions were
significantly more frequentin patients whoneeded oxygen supplementation
(p = 0.007; p = 0.006 andp = 0.001, respectively). This multicentric
study confirmed that LUS is able to detect Covid-19 low respiratory
tract involvement, which is characterized by pleural line
irregularities, vertical artifacts and subpleural consolidations.
Notably, children with higher LUS score have an higher risk of
hospitalization or need for oxygen supplementation, supporting LUS as a
valid and safe point-of-care first level tool for the clinical
evaluation of children with Covid-19.