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

COVID-19 lung ultrasound multisystem inflammatory syndrome in children

Journal

Children (Basel, Switzerland)
ISSN: 2227-9067
Titre abrégé: Children (Basel)
Pays: Switzerland
ID NLM: 101648936

Informations de publication

Date de publication:
21 Jun 2022
Historique:
received: 07 05 2022
revised: 31 05 2022
accepted: 15 06 2022
entrez: 27 7 2022
pubmed: 28 7 2022
medline: 28 7 2022
Statut: epublish

Résumé

Objective and design: 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. The aim of this retrospective observational study conducted between 1 March and 31 December 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. The secondary objective is to evaluate concordance of LUS with Chest X-ray (CXR). Methodology: 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, needed for respiratory support and inotrope administration, hospital, and PICU length of stay, were considered as outcomes and evaluated in the different LUS patterns. An agreement between LUS and CXR evaluation was assessed with Cohen’ k. Results: 24 children, who had a LUS examination upon admission, were enrolled. 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: 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.

Identifiants

pubmed: 35883915
pii: children9070931
doi: 10.3390/children9070931
pmc: PMC9322869
pii:
doi:

Types de publication

Journal Article

Langues

eng

Références

Crit Care. 2015 Feb 06;19:36
pubmed: 25656060
N Engl J Med. 2020 Jul 23;383(4):334-346
pubmed: 32598831
Pediatr Pulmonol. 2021 Jan;56(1):252-263
pubmed: 32926572
Pediatr Radiol. 2020 Aug;50(9):1217-1230
pubmed: 32556807
Acad Emerg Med. 2014 Aug;21(8):843-52
pubmed: 25176151
Obes Rev. 2020 Oct;21(10):e13095
pubmed: 32686331
Pediatr Pulmonol. 2022 Feb;57(2):483-497
pubmed: 34761881
Eur Heart J. 2016 Jul 14;37(27):2097-104
pubmed: 27174289
Eur J Radiol. 2017 Mar;88:82-87
pubmed: 28189214
J Ultrasound Med. 2009 Feb;28(2):163-74
pubmed: 19168766
BMC Pediatr. 2013 Jun 25;13:100
pubmed: 23799966
J Am Soc Echocardiogr. 2010 May;23(5):465-95; quiz 576-7
pubmed: 20451803
Chest. 2008 Jul;134(1):117-25
pubmed: 18403664
J Ultrasound Med. 2016 Oct;35(10):2075-86
pubmed: 27503755
Intensive Care Med. 2012 Apr;38(4):577-91
pubmed: 22392031
Pediatr Radiol. 2020 Sep;50(10):1354-1368
pubmed: 32749530
Paediatr Respir Rev. 2020 Nov;36:136-141
pubmed: 31679983
Ultrasound Med Biol. 2020 Sep;46(9):2546-2550
pubmed: 32507699
Ultrasound Med Biol. 2020 Aug;46(8):2094-2098
pubmed: 32409232
IEEE Trans Ultrason Ferroelectr Freq Control. 2020 Nov;67(11):2265-2273
pubmed: 32746228
Radiology. 2021 Jan;298(1):E1-E10
pubmed: 32584166
J Ultrasound. 2022 Jun;25(2):185-197
pubmed: 34146336
Pediatr Emerg Care. 2015 Dec;31(12):872-5
pubmed: 26626898
Pediatrics. 2020 Jun;145(6):
pubmed: 32179660
Cell. 2020 Nov 12;183(4):968-981.e7
pubmed: 32966765
N Engl J Med. 2020 Apr 23;382(17):1663-1665
pubmed: 32187458
Paediatr Respir Rev. 2021 Jun;38:51-57
pubmed: 32891582
Children (Basel). 2022 Feb 17;9(2):
pubmed: 35204999
J Thromb Haemost. 2021 Jul;19(7):1764-1770
pubmed: 33872443
Eur J Pediatr. 2016 Feb;175(2):163-70
pubmed: 26283293
J Med Virol. 2021 Feb;93(2):1188-1193
pubmed: 32975814
Crit Care. 2020 Nov 26;24(1):666
pubmed: 33243303
Chest. 2020 Aug;158(2):469-470
pubmed: 32768066
PLoS One. 2017 Aug 14;12(8):e0182881
pubmed: 28806783
Rheumatol Int. 2022 Mar;42(3):477-484
pubmed: 34665296
Pediatr Rheumatol Online J. 2021 Feb 24;19(1):21
pubmed: 33627147
J Cardiovasc Pharmacol Ther. 2021 Jan;26(1):12-24
pubmed: 32924567
J Pers Med. 2021 Jul 30;11(8):
pubmed: 34442401
Pediatr Pulmonol. 2018 Aug;53(8):1130-1139
pubmed: 29696826
IEEE Trans Ultrason Ferroelectr Freq Control. 2020 Mar;67(3):612-623
pubmed: 31670665
Chest. 2005 May;127(5):1690-5
pubmed: 15888847
J Clin Ultrasound. 2019 Feb;47(2):63-70
pubmed: 30393878
Eur J Pediatr. 2011 Nov;170(11):1427-33
pubmed: 21468639
J Med Virol. 2021 Jul;93(7):4358-4369
pubmed: 33739452
Pediatr Infect Dis J. 2020 Nov;39(11):e340-e346
pubmed: 32925547
J Ultrasound. 2017 Apr 7;20(2):91-96
pubmed: 28592998

Auteurs

Anna Camporesi (A)

Department of Pediatric Anesthesia and Intensive Care, Children's Hospital "Vittore Buzzi", 20154 Milano, Italy.

Marco Gemma (M)

Department of NeuroAnesthesia and NeuroIntensive Care, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20154 Milano, Italy.

Danilo Buonsenso (D)

Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario "A. Gemelli", 00168 Roma, Italy.

Stefania Ferrario (S)

Department of Pediatric Anesthesia and Intensive Care, Children's Hospital "Vittore Buzzi", 20154 Milano, Italy.

Anna Mandelli (A)

Department of Pediatric Anesthesia and Intensive Care, Children's Hospital "Vittore Buzzi", 20154 Milano, Italy.

Matteo Pessina (M)

Department of Pediatric Anesthesia and Intensive Care, Children's Hospital "Vittore Buzzi", 20154 Milano, Italy.

Veronica Diotto (V)

Department of Pediatric Anesthesia and Intensive Care, Children's Hospital "Vittore Buzzi", 20154 Milano, Italy.

Elena Rota (E)

Department of Pediatric Anesthesia and Intensive Care, Children's Hospital "Vittore Buzzi", 20154 Milano, Italy.

Irene Raso (I)

Department of Pediatric Cardiology, Children's Hospital "Vittore Buzzi", 20154 Milano, Italy.

Laura Fiori (L)

Department of Pediatrics, Children's Hospital "Vittore Buzzi", 20154 Milano, Italy.

Alessandro Campari (A)

Department of Pediatric Radiology, Children's Hospital "Vittore Buzzi", 20154 Milano, Italy.

Francesca Izzo (F)

Department of Pediatric Anesthesia and Intensive Care, Children's Hospital "Vittore Buzzi", 20154 Milano, Italy.

Classifications MeSH