Results:
Thirteen pediatric inpatients (10 female) with confirmed COVID‐19, were
included. All of our cases were exposed to an infected family member.
Epidemiological and clinical features are described in Table 1. Age
ranged from 1 month to 14 years (median 4 years). The clinical
manifestations included fever in all symptomatic cases (10/13),
respiratory symptoms (cough, nasal discharge, croup) in 5/13 cases, and
gastrointestinal symptoms in 2 infants, variably associated. Three
patients (23%) were asymptomatic and were admitted to hospital because
of comorbidities. Except for a single case of respiratory syncytial
virus (RSV) coinfection, none of the included patients required oxygen
or assisted ventilation. Specific treatment for COVID-19 was
administered in 2 patients with oncological comorbidity. At least one or
repeated lung US were performed in all 13 patients; 3 patients underwent
chest-X-ray (#6, #8, #12) and one patient underwent CT scan (#10).
Lung US pattern of our patients is shown in Table 2. Lung US documented
artifacts of respiratory interstitial syndrome as for focal or
coalescent B-lines or white lung in 8/13 patients and a normal A-pattern
was found in 5/13 patients. Among asymptomatic cases, 2 patients showed
normal A-pattern whereas patient #6, affected by subglottic stenosis,
showed posterior bilateral B-lines. Patient #2, which tested positive
for RSV coinfection, showed B-lines and subpleural consolidation. No
patient presented pneumothorax or pleural effusion. The time interval
between symptoms onset and lung US did not seem to affect US pattern.
Six patients were repeatedly examined with lung US on alternate days in
order to follow the evolution, without substantial variations on
ultrasonographic pattern. Just in one case (#1), lung US repeated 4
days after admission showed improvement of the interstitial patterns.
Concordance between lung US and CT scan and X-ray findings was found in
3 patients (#6, #10, #12), when performed at the same time.
Agreement between physician sonographers and the expert sonographer’s
blind review was 100%. The 10 symptomatic patients recovered within 2
to 10 days; no deaths were reported.