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Supino MC, Buonsenso D, Agostiniani R, Gori L, Tipo V, Morello R, Del Monaco G, Falsaperla R, Biagi C, Cazzato S, Villani A, Musolino AM. The lung ultrasound in children with SARS-COV-2 infection: a national multicenter prospective study. Eur J Pediatr 2024; 183:3397-3405. [PMID: 38767693 DOI: 10.1007/s00431-024-05609-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 05/07/2024] [Accepted: 05/11/2024] [Indexed: 05/22/2024]
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.
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Affiliation(s)
- Maria Chiara Supino
- Pediatric Emergency Unit, Pediatric Emergency Department and General Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Centro di Salute Globale, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Laura Gori
- Department of Maternal and Child Health, Division of Pediatric Unit, S. Chiara Hospital, Pisa, Italy
| | - Vincenzo Tipo
- Pediatric Emergency and Short Stay Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Rosa Morello
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Raffaele Falsaperla
- Neonatal Intensive Care Unit [NICU], AOU "Rodolico-San Marco", PO "San Marco", University of Catania, Catania, Italy
| | - Carlotta Biagi
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Salvatore Cazzato
- Pediatric Unit, Department of Mother and Child Health, Salesi Children's Hospital, Ancona, Italy
| | - Alberto Villani
- Pediatric Emergency Unit, Pediatric Emergency Department and General Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Anna Maria Musolino
- Pediatric Emergency Unit, Pediatric Emergency Department and General Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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Stoicescu ER, Lovrenski J, Iacob R, Cerbu S, Iacob D, Iacob ER, Susa SR, Ciuca IM, Bolintineanu (Ghenciu) LA, Ciornei-Hoffman A, Oancea C, Manolescu DL. COVID-19 in Infants and Children under 2 Years-Could Lung Ultrasound Score Be Correlated with Biomarkers and Symptoms? Biomedicines 2023; 11:2620. [PMID: 37892994 PMCID: PMC10604022 DOI: 10.3390/biomedicines11102620] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/13/2023] [Accepted: 09/22/2023] [Indexed: 10/29/2023] Open
Abstract
INTRODUCTION It is already well known that infants and children infected with COVID-19 develop mild to moderate forms of the disease, with fever and oropharyngeal congestion being the most common symptoms. However, there are instances when patients claim to be experiencing respiratory symptoms. Because of the repeated lung examinations required in these situations, non-irradiating imaging techniques are preferred. This study's objective is to ascertain the value of lung ultrasonography (LUS) in the medical management of these specific cases. METHODS Infants and children under two years old with SARS-CoV-2 infection were evaluated using LUS. Patients with other respiratory pathologies were excluded by using specific tests. The LUS score (LUSS) was correlated with biomarkers and clinical findings using the Mann-Whitney U test and Spearman's rank correlation rho. RESULTS The LUSS for each patient varied from 1 to 8 points out of a maximum of 36 points. The arithmetic mean was 4.47 ± 2.36 (S.D), while the 95% CI for the arithmetic mean was 3.33 to 5.61. Sparse B-lines were present in all enrolled infants and children (100%), while only 36.84% developed alveolar syndrome (confluent B-lines). The lung changes were correlated with their biomarkers, specifically inflammatory markers. The correlation between LUSS and LDH, D-dimers, and IL-6 was a strongly positive one with rho = 0.55 (p = 0.001, 95% CI 0.13 to 0.80) between the LUSS and D-dimer levels and rho = 0.60 (p = 0.03, 95% CI 0.04 to 0.87) between LUSS and D-dimer levels at symptomatic infants and children (with respiratory involvement). CONCLUSIONS Infants and children under the age of two are prone to develop mild forms of COVID-19 disease with a B-line pattern on LUS, although inflammatory markers have elevated blood levels. Despite the small sample, D-dimer levels and O2 saturation were correlated with LUSS in patients with respiratory involvement, while similar results were also found in the entire lot.
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Affiliation(s)
- Emil Robert Stoicescu
- Department of Radiology and Medical Imaging, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (E.R.S.); (D.L.M.)
- Research Center for Pharmaco-Toxicological Evaluations, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
- IOSUD/Ph.D. School, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
| | - Jovan Lovrenski
- Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000 Novi Sad, Serbia
- Institute for Children and Adolescent Health Care of Vojvodina, Hajduk Veljkova 10, 21000 Novi Sad, Serbia
| | - Roxana Iacob
- Department of Radiology and Medical Imaging, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (E.R.S.); (D.L.M.)
- IOSUD/Ph.D. School, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
| | - Simona Cerbu
- Department of Radiology and Medical Imaging, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (E.R.S.); (D.L.M.)
| | - Daniela Iacob
- Research Center for Pharmaco-Toxicological Evaluations, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
- Department of Neonatology, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
| | - Emil Radu Iacob
- Department of Pediatric Surgery, ‘Victor Babes’ University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Septimiu Radu Susa
- IOSUD/Ph.D. School, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
| | - Ioana Mihaiela Ciuca
- Pediatric Department, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
| | - Laura Andreea Bolintineanu (Ghenciu)
- IOSUD/Ph.D. School, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
- Department of Functional Sciences, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
| | - Andreea Ciornei-Hoffman
- Department of Anatomy and Embryology, Morphological Sciences, Iuliu Hatieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
- Department of Radiology and Medical Imaging, County Clinical Emergency Hospital, 400347 Cluj-Napoca, Romania
| | - Cristian Oancea
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases (CRIPMRD), ‘Victor Babeș’ University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Department of Pulmonology, ‘Victor Babes’ University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Diana Luminita Manolescu
- Department of Radiology and Medical Imaging, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (E.R.S.); (D.L.M.)
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases (CRIPMRD), ‘Victor Babeș’ University of Medicine and Pharmacy, 300041 Timișoara, Romania
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Tomczonek-Moruś J, Krysiak N, Blomberg A, Depczyk-Bukała M, Tkaczyk M, Zeman K. Role of Lung Ultrasonography (LUS) as a Tool for Evaluating Children with Pediatric Inflammatory Multisystem Syndrome Temporally Associated with SARS-CoV-2 (PIMS-TS). J Clin Med 2023; 12:jcm12082850. [PMID: 37109187 PMCID: PMC10142478 DOI: 10.3390/jcm12082850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 04/04/2023] [Accepted: 04/06/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) is a novel entity. The inflammatory process involves the circulatory, digestive, respiratory, and central nervous systems, as well as the skin. Making a diagnosis requires extensive differential diagnoses, including lung imaging. The aim of our study was to retrospectively assess the pathologies found in lung ultrasound (LUS) in children diagnosed with PIMS-TS and to evaluate the usefulness of the examination in diagnostics and monitoring. METHODS The study group consisted of 43 children diagnosed with PIMS-TS, in whom LUS was performed at least three times, including on admission to hospital, on discharge, and 3 months after disease onset. RESULTS Pneumonia (mild to severe) was diagnosed in 91% of the patients based on the ultrasound image; the same number had at least one pathology, including consolidations, atelectasis, pleural effusion, and interstitial or interstitial-alveolar syndrome. By the time of discharge, the inflammatory changes had completely regressed in 19% of the children and partially in 81%. After 3 months, no pathologies were detected in the entire study group. CONCLUSION LUS is a useful tool for diagnosing and monitoring children with PIMS-TS. Inflammatory lesions of the lungs resolve completely when the generalized inflammatory process subsides.
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Affiliation(s)
- Jolanta Tomczonek-Moruś
- Department of Pediatrics, Immunology and Nephrology, Institute of the Polish Mother's Memorial Hospital in Lodz Poland, 93-338 Lodz, Poland
| | - Natalia Krysiak
- Department of Pediatrics, Immunology and Nephrology, Institute of the Polish Mother's Memorial Hospital in Lodz Poland, 93-338 Lodz, Poland
| | - Agnieszka Blomberg
- Department of Pediatrics, Immunology and Nephrology, Institute of the Polish Mother's Memorial Hospital in Lodz Poland, 93-338 Lodz, Poland
| | - Marta Depczyk-Bukała
- Department of Pediatrics, Immunology and Nephrology, Institute of the Polish Mother's Memorial Hospital in Lodz Poland, 93-338 Lodz, Poland
| | - Marcin Tkaczyk
- Department of Pediatrics, Immunology and Nephrology, Institute of the Polish Mother's Memorial Hospital in Lodz Poland, 93-338 Lodz, Poland
- Department of Pediatrics Nephrology and Immunology, Medical University of Lodz, 90-151 Lodz, Poland
| | - Krzysztof Zeman
- Department of Pediatrics, Immunology and Nephrology, Institute of the Polish Mother's Memorial Hospital in Lodz Poland, 93-338 Lodz, Poland
- Department of Pediatrics Nephrology and Immunology, Medical University of Lodz, 90-151 Lodz, Poland
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Ghezzi M, Longoni E, Munari A, Raso I, Biganzoli G, Zuccotti G, D'Auria E. Lung involvement in children with COVID-19 multisystem inflammatory syndrome. Pediatr Pulmonol 2023; 58:615-618. [PMID: 36345237 PMCID: PMC9877654 DOI: 10.1002/ppul.26224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/30/2022] [Accepted: 11/02/2022] [Indexed: 11/10/2022]
Abstract
Since the beginning of the COVID-19 pandemic, multisystem inflammatory syndrome in children (MIS-C) has been reported in increasing numbers, mostly focusing on cardiac dysfunction. Very few studies have evaluated lung involvement in terms of imaging findings, while data regarding pulmonary function in children with MIS-C are not available. The purpose of our study was to evaluate lung involvement in MIS-C by imaging and lung function by structured light plethysmography (SLP) at hospital admission and 6 months afterwards. Spirometry is the gold standard technique to evaluate lung function in children. However, SLP has the advantage of not requiring contact with the patient, offering an effective solution for the evaluation of lung function during the pandemic. To our knowledge this is the first study that aims to investigate pulmonary function by SLP in children with MIS-C.
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Affiliation(s)
- Michele Ghezzi
- Allergology and Pneumology Unit, V. Buzzi Children's Hospital, Milan, Italy
| | - Emma Longoni
- Department of Pediatrics, V. Buzzi Children's Hospital, Università degli Studi di Milano, Milan, Italy
| | - Alice Munari
- Department of Radiology, V. Buzzi Children's Hospital, Milano, Italy
| | - Irene Raso
- Pediatric Cardiology Unit, "Vittore Buzzi" Children's Hospital, Milano, Italy
| | - Giacomo Biganzoli
- Medical Statistics Unit, Department of Biomedical and Clinical Sciences L. Sacco, "Luigi Sacco" University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Gianvincenzo Zuccotti
- Department of Pediatrics, V. Buzzi Children's Hospital, Università degli Studi di Milano, Milan, Italy.,Department of Biomedical and Clinical Science "L. Sacco", University of Milan, Milan, Italy
| | - Enza D'Auria
- Allergology and Pneumology Unit, V. Buzzi Children's Hospital, Milan, Italy
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Cantinotti M, Marchese P, Assanta N, Pizzuto A, Corana G, Santoro G, Franchi E, Viacava C, Van den Eynde J, Kutty S, Gargani L, Giordano R. Lung Ultrasound Findings in Healthy Children and in Those Who Had Recent, Not Severe COVID-19 Infection. J Clin Med 2022; 11:jcm11205999. [PMID: 36294320 PMCID: PMC9605002 DOI: 10.3390/jcm11205999] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/29/2022] [Accepted: 10/08/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Lung ultrasound (LUS) is gaining consensus as a non-invasive diagnostic imaging method for the evaluation of pulmonary disease in children. Aim: To clarify what type of artifacts (e.g., B-lines, pleural irregularity) can be defined normal LUS findings in children and to evaluate the differences in children who did not experience COVID-19 and in those with recent, not severe, previous COVID-19. Methods: LUS was performed according to standardized protocols. Different patterns of normality were defined: pattern 1: no plural irregularity and no B-lines; pattern 2: only mild basal posterior plural irregularity and no B-lines; pattern 3: mild posterior basal/para-spine/apical pleural irregularity and no B-lines; pattern 4: like pattern 3 plus rare B-lines; pattern 5: mild, diffuse short subpleural vertical artifacts and rare B-lines; pattern 6: mild, diffuse short subpleural vertical artifacts and limited B-lines; pattern 7: like pattern 6 plus minimal subpleural atelectasis. Coalescent B-lines, consolidations, or effusion were considered pathological. Results: Overall, 459 healthy children were prospectively recruited (mean age 10.564 ± 3.839 years). Children were divided into two groups: group 1 (n = 336), those who had not had COVID-19 infection, and group 2 (n = 123), those who experienced COVID-19 infection. Children with previous COVID-19 had higher values of LUS score than those who had not (p = 0.0002). Children with asymptomatic COVID-19 had similar LUS score as those who did not have infections (p > 0.05), while those who had symptoms showed higher LUS score than those who had not shown symptoms (p = 0.0228). Conclusions: We report the pattern of normality for LUS examination in children. We also showed that otherwise healthy children who recovered from COVID-19 and even those who were mildly symptomatic had more “physiological” artifacts at LUS examinations.
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Affiliation(s)
- Massimiliano Cantinotti
- Fondazione G. Monasterio CNR-Regione Toscana, 54100 Massa, Italy
- Institute of Clinical Physiology, 56127 Pisa, Italy
| | - Pietro Marchese
- Fondazione G. Monasterio CNR-Regione Toscana, 54100 Massa, Italy
- Institute of Life Sciences, Scuola Superiore Sant’Anna, 56127 Pisa, Italy
| | - Nadia Assanta
- Fondazione G. Monasterio CNR-Regione Toscana, 54100 Massa, Italy
| | | | - Giulia Corana
- Fondazione G. Monasterio CNR-Regione Toscana, 54100 Massa, Italy
| | - Giuseppe Santoro
- Fondazione G. Monasterio CNR-Regione Toscana, 54100 Massa, Italy
| | - Eliana Franchi
- Fondazione G. Monasterio CNR-Regione Toscana, 54100 Massa, Italy
| | - Cecilia Viacava
- Fondazione G. Monasterio CNR-Regione Toscana, 54100 Massa, Italy
| | - Jef Van den Eynde
- Department of Cardiovascular Sciences, KU Leuven, 3010 Leuven, Belgium
| | - Shelby Kutty
- Helen B. Taussig Heart Center, Department of Pediatrics, Johns Hopkins Hospital, Baltimore, MD 21205, USA
| | - Luna Gargani
- Cardiothoracic Department, University of Pisa, 56127 Pisa, Italy
| | - Raffaele Giordano
- Adult and Pediatric Cardiac Surgery, Department Advanced Biomedical Sciences, University of Naples “Federico II”, 80131 Naples, Italy
- Correspondence: ; Tel./Fax: +39-08-1746-4702
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Abdominal and Thoracic Imaging Features in Children with MIS-C. GASTROENTEROLOGY INSIGHTS 2022. [DOI: 10.3390/gastroent13040032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
(1) Background: Currently, multisystem inflammatory syndrome in children (MIS-C) is diagnosed based on clinical symptoms and laboratory findings of inflammation in the body. Once MIS-C is diagnosed, children will need to be followed over time. The imaging modalities most commonly used in the evaluation of patients with MIS-C include radiographs, ultrasound (US), and computed tomography (CT). Our study aims to summarise the literature data for the main gastrointestinal and pulmonary imaging features in children diagnosed with MIS-C and to share a single-centre experience. (2) Methods: We present the imaging findings in a cohort of 51 children diagnosed with MIS-C, admitted between December 2020 and February 2022. Imaging studies include chest and abdominal radiographs, thoracic, abdominal, and neck US and echocardiography (ECHO), and CT of the chest, abdomen, and pelvis. (3) Results: In accordance with the results in other studies, our observations show predominantly gastrointestinal involvement (GI) with ascites (33/51, 65%) and lymphadenopathy (19/51, 37%), ileitis or colitis (18/51, 35%), some cases of splenomegaly (9/51, 18%), hepatomegaly (8/51, 16%), and a few cases of renal enlargement (3/51, 6%) and gallbladder fossa oedema/wall thickening (2/51, 4%). Most common among the thoracic findings are posterior–basal consolidations (16/51, 31%), pleural effusion (14/51, 27%), and ground-glass opacities (12/51, 24%). We also register the significant involvement of the cardiovascular system with pericarditis (30/51, 58%), pericardial effusion (16/51, 31%), and myocarditis (6/51, 12%). (4) Conclusions: Radiologists should be aware of those imaging findings in order to take an important and active role not only in applying an accurate diagnosis, but also in the subsequent management of children with MIS-C. Radiological findings are not the primary diagnostic tool, but can assist in the evaluation of the affected systems and guide treatment.
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Buonsenso D, Vetrugno L. Lung Ultrasound in Adults and Children with COVID-19: From First Discoveries to Recent Advances. J Clin Med 2022; 11:4340. [PMID: 35893430 PMCID: PMC9331199 DOI: 10.3390/jcm11154340] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 07/24/2022] [Indexed: 02/04/2023] Open
Abstract
During this pandemic, the lung ultrasound (LUS) imaging modality has shown promising results as a diagnostic, prognostic and monitoring tool for COVID-19 patients [...].
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Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00120 Rome, Italy
- Centro di Salute Globale, Università Cattolica del Sacro Cuore, 00120 Rome, Italy
| | - Luigi Vetrugno
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy
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Buonsenso D. Partnerships in the Comprehensive Management of Multisystem Inflammatory Syndrome in Neonates (MIS-N): Translating 2 Years of Pediatric Practice to the Neonatal Wards. Am J Perinatol 2022. [PMID: 35240695 DOI: 10.1055/a-1787-8099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Center for Global Health Research Studies, Università Cattolica del Sacro Cuore, Roma, Italia.,Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Multisystem Inflammatory Syndrome in Neonates Born to Mothers with SARS-CoV-2 Infection (MIS-N) and in Neonates and Infants Younger Than 6 Months with Acquired COVID-19 (MIS-C): A Systematic Review. Viruses 2022; 14:v14040750. [PMID: 35458480 PMCID: PMC9024762 DOI: 10.3390/v14040750] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/24/2022] [Accepted: 03/31/2022] [Indexed: 12/25/2022] Open
Abstract
(1) Introduction: There is an increasing literature describing neonates born to mothers with SARS-CoV-2 infection (MIS-N) and infants infected with SARS-CoV-2 who presented with a severe disease (MIS-C). (2) Methods: To investigate clinical features of multisystem inflammatory syndrome in neonates and infants under six months of age, we used a systematic search to retrieve all relevant publications in the field. We screened in PubMed, EMBASE and Scopus for data published until 10 October 2021. (3) Results: Forty-eight articles were considered, including 29 case reports, six case series and 13 cohort studies. Regarding clinical features, only 18.2% of MIS-N neonates presented with fever; differently from older children with MIS-C, in which gastrointestinal symptoms were the most common manifestation, we displayed that cardiovascular dysfunction and respiratory distress are the prevalent findings both in neonates with MIS-N and in neonates/infants with MIS-C. (4) Conclusions: We suggest that all infants with suspected inflammatory disease should undergo echocardiography, due to the possibility of myocardial dysfunction and damage to the coronary arteries observed both in neonates with MIS-N and in neonates/infants with MIS-C. Moreover, we also summarize how they were treated and provide a therapeutic algorithm to suggest best management of these fragile infants.
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