Abstract：
Coronavirus disease-19 (COVID-19) caused hospitalizations, severe disease, and deaths in any age, including in the youngest children. The aim of this multicenter national study is to characterize the clinical and the prognostic role of lung ultrasound (LU) in children with COVID-19. We enrolled children between 1 month and 18 years of age with severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection who underwent a LU within 6 h from the first medical evaluation. A total of 213 children were enrolled, 51.6% were male, median age was 2 years and 5 months (interquartile range (IQR) 4 months -11 years and 4 months). One hundred and forty-eight (69.4%) children were admitted in hospital, 9 (6.1%) in pediatric intensive care unit. We found an inverse correlation between the lung ultrasound score (LUS) and the oxygen saturation at the first clinical evaluation (r = -0.16; p = 0.019). Moreover, LUS was significantly higher in patients requiring oxygen supplementation (8 (IQR 3-19) vs 2 (IQR 0-4); p = 0.001). Among LU pathological findings, irregular pleural lines, subpleural consolidations, and pleural effusions were significantly more frequent in patients needing oxygen supplementation (p = 0.007, p = 0.006, and p = 0.001, respectively). Conclusion: This multicenter study showed that LU in children with COVID-19 can highlight pleural line irregularities, vertical artifacts, and subpleural consolidation. Notably, children with higher LUS have a higher risk of hospitalization and need for oxygen supplementation, supporting LU as a valid and safe point-of-care first level tool for the clinical evaluation of children with COVID-19. What is Known: • Few children infected with SARS-CoV-2 develop a severe disease and need oxygen therapy. • Lung ultrasound can easily detect low respiratory tract infection during SARS-CoV-2. What is New: • Children with higher lung ultrasound score have a higher risk of need for oxygen supplementation. • Irregular pleural line, sub-pleural consolidations and pleural effusions were significantly more frequent in patients needing oxygen supplementation.
摘要：
冠状病毒病-19（COVID-19）导致住院，严重疾病,和任何年龄的死亡，包括最小的孩子。这项多中心国家研究的目的是描述肺部超声（LU）在COVID-19儿童中的临床和预后作用。我们招募了1个月至18岁之间患有严重急性呼吸道综合症冠状病毒2（SARS-CoV2）感染的儿童，这些儿童在首次医学评估后6小时内接受了LU。共有213名儿童入学,51.6%为男性,中位年龄为2岁5个月(四分位距(IQR)4个月~11岁4个月).一百四十八名(百分之六十九点四)儿童入院,儿科重症监护病房9人（6.1%）。我们发现在首次临床评估时，肺部超声评分（LUS）与氧饱和度之间呈负相关（r=-0.16；p=0.019）。此外，需要补充氧气的患者的LUS显着升高（8（IQR3-19）vs2（IQR0-4）；p=0.001）。在LU病理发现中，不规则的胸膜线，胸膜下巩固，在需要补充氧气的患者中，胸腔积液的发生率明显更高（分别为p=0.007，p=0.006和p=0.001）。结论：这项多中心研究表明，COVID-19患儿的LU可以突出胸膜线不规则，垂直伪影，和胸膜下巩固。值得注意的是,LUS较高的儿童住院风险较高，需要补充氧气，支持LU作为一种有效和安全的护理点一级工具，用于COVID-19儿童的临床评估。已知:•很少感染SARS-CoV-2的儿童发展为严重的疾病并需要氧疗。•在SARS-CoV-2期间，肺部超声可以轻松检测下呼吸道感染。新增内容：•肺部超声评分较高的儿童需要补充氧气的风险较高。•不规则的胸膜线，需要补充氧气的患者的胸膜下合并和胸腔积液明显更频繁。
