Lung Ultrasound Patterns in Multisystem Inflammatory Syndrome in Children (Mis-C): Characteristics and Prognostic Value

ABSTRACT

BACKGROUND AND AIM: Following Covid-19 infection, children can develop an hyperinflammatory state termed Multisystem Inflammatory Syndrome in Children (MIS-C). Lung Ultrasound (LUS) features of COVID-19 in children have been described but data describing the LUS findings of MIS-C are limited. Aim of this retrospective observational study conducted between March, 1st, and December 31st, 2020, at a tertiary pediatric hospital in Milano, is to describe LUS patterns in patients with MIS-C and to verify correlation with illness severity. Secondary objective is to evaluate concordance of LUS with Chest X-Ray (CXR). METHOD(S) Clinical and laboratory data were collected for all patients (age 0-18 years) admitted with MIS-C, as well as LUS and CXR patterns at admission. PICU admission, need for respiratory support and inotrope administration, hospital and PICU length of stay were considered as outcomes and evaluated in the different LUS patterns. Agreement between LUS and CXR evaluation was assessed with Cohen' k. RESULT(S) 38 children were enrolled;24 had a LUS examination upon admission. LUS pattern of subpleural consolidations < or > 1 cm with or without pleural effusion were associated with worse Left Ventricular Ejection Fraction at admission and need for inotropes. Subpleural consolidations < 1 cm were also associated with PICU length of stay. Agreement of CXR with LUS for consolidations and effusion was slight. CONCLUSION(S) LUS pattern of subpleural consolidations and consolidations with or without pleural effusion are predictors of disease severity;under this aspect, LUS can be used at admission to stratify risk of severe disease.