Lung Ultrasound Useful for Tracking COVID-19 in Children

By Will Boggs MD

June 17, 2020

NEW YORK (Reuters Health) - Lung ultrasound findings are consistent with radiologic findings in children with COVID-19, researchers in Italy report.

"Given the high agreement between lung ultrasound (LUS) and chest x-ray, physicians may trust in LUS findings in the clinical evaluation and follow-up of children with mild to severe COVID-19," Dr. Marco Denina of Regina Margherita Children's Hospital, University of Turin, told Reuters Health by email.

LUS has recognized validity for diagnosing and following up pneumonia in pediatric patients, but there are no data about the use of LUS in children with COVID-19.

Dr. Denina and colleagues present the LUS and chest x-ray findings of eight children affected by COVID-19 in a report in Pediatrics.

Two children had severe clinical disease, two had moderate disease, and four had mild COVID-19. Two children required noninvasive oxygen therapy, but none required mechanical ventilation.

LUS findings included subpleural consolidations in two children and confluent B-lines in five children.

LUS concorded with radiologic findings in seven of the eight patients, and in the remaining patient, an interstitial B-lines pattern was observed on LUS despite normal chest radiography.

In one child with severe clinical illness, the B-lines bilateral pattern on LUS diminished a day in advance of clinical and radiographic improvement.

Repeated LUS in seven children with pathologic findings at baseline revealed improvement or resolution of all consolidations and interstitial patterns before discharge that were consistent with the concomitant radiographic findings.

"Although additional studies are needed to better understand and characterize LUS findings in this novel disease in children, we propose routine LUS protocol examinations as a useful tool in the diagnostic and clinical management of mild or severe COVID-19 in children," the authors conclude.

"Implementing the use of LUS in bedside examinations of COVID-19-affected children may reduce both the radiation exposure of the patients and the patients' movement within the hospital, thus lowering the number of healthcare workers and medical devices exposed to SARS-CoV-2," Dr. Denina said.

SOURCE: Pediatrics, online June 16, 2020.