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1.
Children (Basel) ; 9(5)2022 May 23.
Article in English | MEDLINE | ID: covidwho-1953083

ABSTRACT

During the COVID-19 pandemic, the lung ultrasound (LU) turned out to be a pivotal tool to study the lung involvement in the adult population, but the same was not well evaluated in children. We detected the LU patterns through an integrated approach with clinical-laboratory features in children hospitalized for COVID-19 in relation to the temporal trend of the Italian epidemic. We conducted a retrospective study which took place at a pediatric tertiary hospital from 15 March 2020 to 15 March 2021. We compared the characteristics of the initial phase of the first COVID-19 year-in the spring and summer (15 March-30 September 2020)-and those of the second phase-in the autumn and winter (1 October 2020-15 March 2021). Twenty-eight patients were studied both in the first and in the second phase of the first COVID-19 year. The disease severity score (DSS) was significantly greater in the second phase (p = 0.015). In the second phase of the first COVID-19 year, we detected a more significant occurrence of the following LU features than in the first phase: the irregular pleural line (85.71% vs. 60.71%; p = 0.035), the B-lines (89.29% vs. 60%; p = 0.003) and the several but non-coalescent B-lines (89.29% vs. 60%; p = 0.003). The LU score correlated significantly with the DSS, with a moderate relationship (r = 0.51, p < 0.001). The combined clinical, laboratory and ultrasound approaches might be essential in the evaluation of pulmonary involvement in children affected by COVID-19 during different periods of the pandemic.

2.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-317622

ABSTRACT

Background: The aim of this study was to analyze the lung ultrasound (LUS) patterns in combination with clinical-laboratory profiles of children hospitalized for COVID-19 infection in relation to temporal trend of the Italian epidemic. Methods: This was a retrospective study conducted at a pediatric tertiary referral hospital from 15th March 2020 to 15th March 2021. We compared the characteristics of two periods of the pandemic outbreak, the first one in spring and summer (15th March-30th September 2020) and the second one in autumn and winter (1st October 2020-15th March 2021). Results: 28 patients (53.85%) were in the first period, 24 patients (46.15%) were in the second period. The disease severity score was significantly higher in the second period (p=0.02). We observed that the occurrence of the irregular pleural line was seen more frequently in the second period (87.5% vs 60.71%;p=0.03). The B-lines were significantly more frequent in children in the second period (87.5% vs 60%;p=0.03). The several but not-coalescent B-lines were significantly more frequent in the second period (80% vs 41.7%;p=0.05). The LUS score correlated significantly with the disease severity score with a strong relationship (r=0.51, p=0.002). The second phase of the COVID-19 epidemic outbreak had a higher disease severity score than the first phase with a moderate correlation (r= 0.42;p=0.01). Conclusion: The LUS plays an important role in the evaluation of pulmonary involvement in children affected by COVID-19 during different periods of the pandemic in combination with clinical-laboratory findings.

3.
J Clin Med ; 11(1)2022 Jan 01.
Article in English | MEDLINE | ID: covidwho-1580628

ABSTRACT

BACKGROUND: To date, there are no data regarding the systematic application of Point-of-Care Lung Ultrasound (PoC-LUS) in children with Multisystem Inflammatory Syndrome in Children (MIS-C). The main aim of this study is to show the role of Point-of-Care Lung Ultrasound as an additional aid in the diagnosis of COVID-19-related Multisystem Inflammatory Syndrome in Children (MIS-C). METHODS: Between April 2020 and April 2021, patients aged 0-18 years referred to our emergency department for fever, and later hospitalized without a specific diagnosis, underwent PoC-LUS. Ultrasound images of patients with a final diagnosis of MIS-C were retrospectively evaluated. RESULTS: Ten patients were enrolled. All were described to have pleural irregularities and B-lines. In particular: 8/10 children presented with isolated B-lines in at least half of the lung areas of interest; 8/10 presented with multiple B-lines and 3/8 had them in at least 50% of lung areas; 5/10 had a white lung appearance in at least one lung area and 1/5 had them in half of the areas of interest. Pleural effusion was described in 9/10. CONCLUSIONS: During the ongoing COVID-19 pandemic, we suggest performing PoC-LUS in febrile patients with high levels of inflammatory indices and clinical suspicion of MIS-C, or without a certain diagnosis; the finding of many B-lines and pleural effusion would support the diagnosis of a systemic inflammatory disease.

4.
J Paediatr Child Health ; 57(5): 604-606, 2021 05.
Article in English | MEDLINE | ID: covidwho-1115062

ABSTRACT

Point-of-care lung ultrasound is a widely used tool in the diagnosis and management of patients with pulmonary diseases and now with SARS-CoV-2 infection. We describe two cases of pneumothorax which are, as far as we know, among the first reported in COVID-19 patients younger than 18 years. The diagnostic and monitoring role of point-of-care lung ultrasound has been extremely useful in the management of patients.


Subject(s)
COVID-19 , Pneumothorax , COVID-19 Testing , Child , Humans , Lung/diagnostic imaging , Pneumothorax/diagnostic imaging , Pneumothorax/etiology , Point-of-Care Systems , SARS-CoV-2 , Ultrasonography
5.
Ital J Pediatr ; 46(1): 180, 2020 Dec 07.
Article in English | MEDLINE | ID: covidwho-963305

ABSTRACT

BACKGROUND: Lately, one of the major clinical and public health issues has been represented by Coronavirus disease of 2019 (COVID-19) during pregnancy and the risk of transmission of the infection from mother to child. Debate on perinatal management and postnatal care is still ongoing, principally questioning the option of the joint management of mother and child after birth and the safety of breastfeeding. According to the available reports, neonatal COVID-19 appears to have a horizontal transmission and seems to be paucisymptomatic or asymptomatic, compared to older age groups. The aim of this work is to describe a cluster of neonatal COVID-19 and discuss our experience, with reference to current evidence on postnatal care and perinatal management. METHODS: This is a retrospective observational case series of five mother-child dyads, who attended the Labor and Delivery Unit of a first-level hospital in Italy, in March 2020. Descriptive statistics for continuous variables consisted of number of observations, mean and the range of the minimum and maximum values. RESULTS: Five women and four neonates tested positive for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). In one case, the mother-child dyad was separated and the neonate remained negative on two consecutive tests. Two positive neonates developed symptoms, with a predominant involvement of the gastrointestinal tract. Blood tests were unremarkable, except for a single patient who developed mild neutropenia. No complications occurred. CONCLUSIONS: We agree that the decision on whether or not to separate a positive/suspected mother from her child should be made on an individual basis, taking into account the parent's will, clinical condition, hospital logistics and the local epidemiological situation. In conformity with literature, in our study, affected neonates were asymptomatic or paucisymptomatic. Despite these reassuring findings, a few cases of severe presentation in the neonatal population have been reported. Therefore, we agree on encouraging clinicians to monitor the neonates with a suspected or confirmed infection.


Subject(s)
COVID-19/therapy , COVID-19/transmission , Disease Transmission, Infectious , Mothers , Postnatal Care , Adult , COVID-19/epidemiology , COVID-19 Testing , Female , Humans , Infant, Newborn , Italy/epidemiology , Male , Pandemics , Retrospective Studies , SARS-CoV-2
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