ECHOPAEDIA: Echography in Paediatric Patients in the Age of Coronavirus Disease 2019: Utility of Lung Ultrasound and Chest X-Ray in Diagnosis of Community-Acquired Pneumonia and Severe Acute Respiratory Syndrome Coronavirus 2 Pneumonia

Frontiers in Pediatrics

article

Ivan Fiorito¹  Giulia Gori²  Tiziano Perrone³  Amelia Mascolo¹  Silvia Caimmi¹  Ilaria Palumbo²  Annalisa De Silvestri⁴  Mariangela Delliponti²  Antonio Di Sabatino²  Gian Luigi Marseglia¹ 

[1] Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia;Department of Internal Medicine, Foundation IRCCS Policlinico San Matteo, University of Pavia;Emergency Unit;Unit of Clinical Epidemiology and Biometrics, Foundation IRCCS Policlinico San Matteo, University of Pavia

关键词: lung ultrasound;    pneumonia;    children;    LUS score;    SARS-CoV-2;   

DOI  :  10.3389/fped.2022.813874

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background In recent years, lung ultrasound (LUS) has spread to emergency departments and clinical practise gaining great support, especially in time of pandemic, but only a few studies have been done on children. The aim of the present study is to compare the diagnostic accuracy of LUS (using Soldati LUS score) and that of chest X-ray (CXR) in CAP and COVID-19 pneumonia in paediatric patients. Secondary objective of the study is to examine the association between LUS score and disease severity. Finally, we describe the local epidemiology of paediatric CAP during the study period in the era of COVID-19 by comparing it with the previous 2 years. Methods This is an observational retrospective single-centre study carried out on patients aged 18 or younger and over the month of age admitted to the Paediatric Unit of our Foundation for suspected community-acquired pneumonia or SARS-CoV-2 pneumonia during the third pandemic wave of COVID-19. Quantitative variables were elaborated with Shapiro–Wilks test or median and interquartile range (IQR). Student's t -test was used for independent data. Association between quantitative data was evaluated with Pearson correlation. ROC curve analysis was used to calculate best cut-off of LUS score in paediatric patients. Area under the ROC curve (AUC), sensibility, and specificity are also reported with 95% confidence interval (CI). Results The diagnostic accuracy of the LUS score in pneumonia, the area underlying the ROC curve (AUC) was 0.67 (95% CI: 0.27–1) thus showing a discrete discriminatory power, with a sensitivity of 89.66% and specificity 50% setting a LUS score greater than or equal to 1 as the best cut-off. Nine patients required oxygen support and a significant statistical correlation ( p = 0.0033) emerged between LUS score and oxygen therapy. The mean LUS score in patients requiring oxygen therapy was 12. RCP was positively correlated to the patient's LUS score ( p = 0.0024). Conclusions Our study has shown that LUS is a valid alternative to CXR. Our results show how LUS score can be applied effectively for the diagnosis and stratification of paediatric pneumonia.

【 授权许可】

CC BY