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.