Department of Pediatric Pulmonology, Ankara Training and Research Hospital, University of Health Science, Ankara, Turkey.
Department of Pediatric Infectious Disease, Ankara Training and Research Hospital, University of Health Science, Ankara, Turkey.
Pediatr Pulmonol. 2021 May;56(5):1018-1025. doi: 10.1002/ppul.25127. Epub 2020 Nov 27.
Lung ultrasound (LUS) has been successfully used in the diagnosis of different pulmonary diseases. Present study design to determine the diagnostic value of LUS in the evaluation of children with novel coronavirus disease 2019 (COVID-19).
Prospective multicenter study, 40 children with confirmed COVID-19 were included. LUS was performed to all patients at admission. The chest X-ray and computed tomography (CT) were performed according to the decision of the primary physicians. LUS results were compared with chest X-ray and CT findings and diagnostic performance was determined.
Of the 40 children median (range) was 10.5 (0.4-17.8) years. Chest X-ray and LUS were performed on all and chest CT was performed on 28 (70%) patients at the time of diagnosis. Sixteen (40%) patients had no apparent chest CT abnormalities suggestive of COVID-19, whereas 12 (30%) had abnormalities. LUS confirmed the diagnosis of pulmonary involvement in 10 of 12 patients with positive CT findings. LUS demonstrated normal lung patterns among 15 of 16 patients who had normal CT features. The sensitivity and the area under the receiver operating characteristics (ROC) curve (area under the ROC curve) identified by the chest X-ray and LUS tests were compared and statistically significantly different (McNemar's test: p = .016 and p = .001 respectively) detected. Chest X-ray displayed false-negative results for pulmonary involvement in 75% whereas for LUS it was 16.7%.
LUS might be a useful tool in the diagnostic steps of children with COVID-19. A reduction in chest CT assessments may be possible when LUS is used in the initial diagnostic steps for these children.
肺部超声（LUS）已成功用于诊断各种肺部疾病。本研究旨在确定 LUS 在评估新型冠状病毒病 2019（COVID-19）儿童中的诊断价值。
前瞻性多中心研究，纳入 40 例确诊 COVID-19 的儿童。所有患者入院时均行 LUS 检查。根据初级医师的决定进行胸部 X 线和计算机断层扫描（CT）检查。将 LUS 结果与胸部 X 线和 CT 结果进行比较，并确定诊断性能。
40 名儿童的中位数（范围）为 10.5（0.4-17.8）岁。所有患者均行胸部 X 线和 LUS 检查，28 例（70%）患者在诊断时行胸部 CT 检查。16 例（40%）患者无明显胸部 CT 异常提示 COVID-19，12 例（30%）患者有异常。LUS 证实 12 例 CT 阳性患者中有 10 例存在肺部受累。16 例 CT 特征正常的患者中有 15 例 LUS 显示正常肺部模式。胸部 X 线和 LUS 检测的敏感性和受试者工作特征曲线（ROC 曲线下面积）（ROC 曲线下面积）进行比较，差异具有统计学意义（McNemar 检验：p=0.016 和 p=0.001）。胸部 X 线对肺部受累的假阴性率为 75%，而 LUS 为 16.7%。
LUS 可能是 COVID-19 儿童诊断步骤中的有用工具。当 LUS 用于这些儿童的初始诊断步骤时，可能可以减少胸部 CT 评估。
