Lung ultrasound may be useful in managing children with COVID-19

 1. In a small study of children with COVID-19 in Italy, point of care lung ultrasound findings correlated with radiographic findings in 7 of 8 patients. In the remaining patient, abnormal ultrasound findings were observed despite a normal chest x-ray

2. Repeat ultrasounds prior to discharge showed improvement in concordance with radiologic and clinical findings.

Evidence Rating Level: 4 (Below Average)

Study Rundown [case series]: Lung ultrasound (LUS) has been shown to be effective in diagnosing pediatric pneumonia. The use of point of care ultrasound in patients with COVID-19 decreases patient transport as well as provider and machine exposure to the highly contagious SARS-CoV-2. LUS correlated with chest CT findings in one study of adult COVID-19 patients in Italy. Authors of this study sought to determine whether LUS findings in pediatric inpatients with COVID-19 correlated with radiographic findings. Participants included 8 children aged 0-17 years with documented COVID-19 admitted to a children’s hospital in Italy between March 18 and March 26, 2020. Disease severity was classified as severe in 2 patients, moderate in 2 patients, and mild in 4 patients. LUS revealed pathologic findings in all 8 patients at baseline. In 7/8 patients, these findings correlated with chest x-ray findings. In the remaining patient, pathologic LUS findings were observed in the absence of abnormal chest radiography. Repeat LUS findings in all patients improved along with radiographic and clinical improvement prior to discharge. Although limited by a small sample size, this study shows that LUS may be a useful alternative to chest radiography in diagnosing and monitoring lung pathology in pediatric patients with COVID-19. Advantages of LUS include lack of radiation exposure to the child and reduction of patient movement within the hospital and thus exposure to other health care workers. Additionally, the ultrasound probe and tablet can be easily wrapped in plastic covers, reducing the risk of contamination.

Click to read the study in Pediatrics

Relevant Reading: Lung ultrasound for the diagnosis of pneumonia in children: a meta-analysis (Pediatrics 2015)

Image: PD

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