Pediatric COVID-19 Follow-Up with Lung Ultrasound: A Prospective Cohort Study

Abstract

During the COVID-19 pandemic, lung ultrasound (LUS) was widely used to assess SARS-CoV-2 infection. To date, there are patients with persistence of symptoms after acute infection. Therefore, it may be useful to have an objective tool to follow these patients. The aim of our study was to evaluate the presence of LUS artifacts after SARS-CoV-2 infection in children and to analyze the associations between time elapsed since infection and symptomatology during acute infection. We conducted an observational study, enrolling 607 children infected with SARS-CoV-2 in the previous twelve months. All patients performed a LUS and medical history of demographic and clinical data. We observed irregular pleural lines in 27.5%, B-lines in 16.9%, and subpleural consolidations in 8.6% of the cases. These artifacts were more frequently observed in the lower lobe projections. We have observed that the frequency of artifacts decreases with increasing time since infection. In symptomatic patients during COVID infection, B-lines (p = 0.02) were more frequently found. In our sample, some children, even after months of acute infection, have ultrasound artifacts and showed an improvement with the passage of time from the acute episode. Our study provides additional evidence about LUS in children with previous COVID-19 as a support to follow these patients in the months following the infection.

Keywords: COVID-19; SARS-CoV-2 infection; children; lung ultrasound.

Figure 1

Enrolment flow-chart.

Figure 2

Lung ultrasound patterns with the degree of pulmonary aeration.

Figure 3

Association between artefacts (A) ─ patterns (B) lung ultrasound and time elapsed since infection.

Figure 4

Association between lung ultrasound artifacts and Body Mass Index. Data not statistically significant have not been reported (subpleural consolidation and Pattern C).