ÖZET
Giriş:
Yeni Koronavirüs hastalığı-2019 (COVID-19) enfeksiyonu dünya çapında hem yetişkinleri hem de çocukları etkilemeye devam etmektedir. COVID-19’lu yetişkin hastalarda ultrasonografi bulgularını tanımlayan çalışmalar olmasına rağmen, çocuklarda ultrasonografinin tanısal kullanımına ilişkin sınırlı veri mevcuttur. Bu çalışmada, COVID- 19’lu çocuk hastalarda yapılan yatak başı akciğer ultrasonografisi (LUS) sonuçlarının değerlendirilmesi amaçlanmaktadır.
Yöntemler:
Çalışmaya COVID-19 tanısı almış çocuk hastalar dahil edildi. Tüm akciğer alanları LUS ile görüntülendi ve demografik, klinik ve laboratuvar verileri ve akciğer grafisi (CXR) bulguları ile birlikte değerlendirildi.
Bulgular:
Yaş ortalaması 9,65±4,78 (en az 35 gün-en fazla 17) yıl olan 54 kız ve 48 erkek olmak üzere 102 çocuk hasta değerlendirildi. Hastaların %46’sında solunum sistemi semptomları, %36’sı semptomsuz ve %18’inde solunum sistemi dışında semptomlar vardı. Hastaların %36’sında CXR’de, %57’sinde LUS’de patolojik bulgular saptandı. LUS ve CXR arasındaki patolojik bulguların saptanma oranlarındaki fark istatistiksel olarak anlamlıydı (p=0,001). CXR’si normal olan 65 hastanın 29’unda LUS’de patoloji gözlendi. Solunum semptomları olan hastalarda patolojiyi saptamadaki duyarlılık oranı CXR'de %49 ve LUS’de %77 idi (p=0,001).
Sonuç:
Solunum semptomları olan COVID-19 hastalarında akciğer tutulumunu göstermede LUS’nin duyarlılığının CXR’den daha yüksek olduğunu belirledik. LUS, COVID-19’lu çocuk hastaların değerlendirilmesinde yardımcı olabilir, ancak çocuklarda uygulanabilirliğini kanıtlamak için daha fazla çalışmaya ihtiyaç vardır.
References
1
Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382:1708-20.
2
Haak SL, Renken IJ, Jager LC, Lameijer H, van der Kolk BBY. Diagnostic accuracy of point-of-care lung ultrasound in COVID-19. Emerg Med J. 2021;38:94-9.
3
Fang Y, Zhang H, Xie J, Lin M, Ying L, et al. Sensitivity of chest CT for COVID-19: comparison to RT-PCR. Radiology. 2020;296:E115-E17.
4
Prokop M, Van Everdingen W, van Rees Vellinga T, Quarles van Ufford H, Stöger L, et al. CO-RADS: a categorical CT assessment scheme for patients suspected of having COVID-19—definition and evaluation. Radiology. 2020;296:E97-E104.
5
Lerchbaumer MH, Lauryn JH, Bachmann U, Enghard P, Fischer T, et al. Point-of-care lung ultrasound in COVID-19 patients: Inter-and intra-observer agreement in a prospective observational study. Sci Rep. 2021;11:10678.
6
Vetrugno L, Bove T, Orso D, Barbariol F, Bassi F, et al. Our Italian experience using lung ultrasound for identification, grading and serial follow-up of severity of lung involvement for management of patients with COVID-19. Echocardiography. 2020;37:625-7.
7
Soldati G, Smargiassi A, Inchingolo R, Buonsenso D, Perrone T, et al. Proposal for international standardization of the use of lung ultrasound for patients with COVID-19: a simple, quantitative, reproducible method. J Ultrasound Med. 2020;39:1413-9.
8
Fang F, Chen Y, Zhao D, Liu T, Huang Y, et al. Recommendations for the diagnosis, prevention, and control of coronavirus disease-19 in children-the Chinese perspectives. Front Pediatr. 2020;8:553394.
9
Taylor E, Haven K, Reed P, Bissielo A, Harvey D, et al. A chest radiograph scoring system in patients with severe acute respiratory infection: a validation study. BMC Med Imaging. 2015;15:61.
10
Manivel V, Lesnewski A, Shamim S, Carbonatto G, Govindan T. CLUE: COVID-19 lung ultrasound in emergency department. Emerg Med Australas. 2020;32:694-9.
11
Pare JR, Camelo I, Mayo KC, Leo MM, Dugas JN, et al. Point-of-care lung ultrasound is more sensitive than chest radiograph for evaluation of COVID-19. West J Emerg Med. 2020;21:771-8.
12
Palabiyik F, Kokurcan SO, Hatipoglu N, Cebeci SO, Inci E. Imaging of COVID-19 pneumonia in children. Br J Radiol. 2020;93:20200647.
13
Ai T, Yang Z, Hou H, Chen C, Lv W, et al. Correlation of chest CT and RT-PCR testing for coronavirus disease 2019 (COVID-19) in China: a report of 1014 cases. Radiology. 2020;296:E32-E40.
14
Parri N, Lenge M, Cantoni B, Arrighini A, Romanengo M, et al. COVID-19 in 17 Italian pediatric emergency departments. Pediatrics. 2020;146:e20201235.
15
Zhang Y, Xie R-M, He Y-L, Xing LH, Dong L, et al. Clinical and imaging features of pediatric COVID-19. Ital J Pediatr. 2020;46:1-9.
16
Han YN, Feng ZW, Sun LN, Ren XX, Wang H, et al. A comparative-descriptive analysis of clinical characteristics in 2019-coronavirus-infected children and adults. J Med Virol. 2020;92:1596-602.
17
Balasubramanian S, Rao NM, Goenka A, Roderick M, Ramanan AV. Coronavirus disease 2019 (COVID-19) in children-what we know so far and what we do not. Indian Pediatr. 2020;57:435-42.
18
Sun D, Li H, Lu XX, Xiao H, Ren J, et al. Clinical features of severe pediatric patients with coronavirus disease 2019 in Wuhan: a single center’s observational study. World J Pediatr. 2020:1:251-9.
19
Lu X, Zhang L, Du H, Zhang J, Li YY, et al. SARS-CoV-2 infection in children. N Engl J Med. 2020;382:1663-5.
20
Dong Y, Mo X, Hu Y, Qi X, Jiang F, et al. Epidemiology of COVID-19 among children in China. Pediatrics. 2020;145:e20200702.
21
Gregori G, Sacchetti R. Lung ultrasound in outpatient approach to children with suspected COVID 19. Ital J Pediatr. 2020;46:171.
22
Giorno EP, De Paulis M, Sameshima YT, Weerdenburg K, Savoia P, et al. Point-of-care lung ultrasound imaging in pediatric COVID-19. Ultrasound J. 2020;12:50.
23
Shen KL, Yang YH, Jiang RM, Wang TY, Zhao DC, et al. Updated diagnosis, treatment and prevention of COVID-19 in children: experts’ consensus statement (condensed version of the second edition). World J Pediatr. 2020;16:232-9.
24
Zimmermann P, Curtis N. Coronavirus infections in children including COVID-19: an overview of the epidemiology, clinical features, diagnosis, treatment and prevention options in children. Pediatr Infect Dis J. 2020;39:355-68.
25
Lu Y, Wen H, Rong D, Zhou Z, Liu H. Clinical characteristics and radiological features of children infected with the 2019 novel coronavirus. Clin Radiol. 2020;75:520-5.
26
Chung M, Bernheim A, Mei X, Zhang N, Huang M, et al. CT imaging features of 2019 novel coronavirus (2019-nCoV). Radiology. 2020;295:202-7.
27
Walsh P, Hankins A, Bang H. Point of care lung ultrasound is useful when screening for CoVid-19 in Emergency Department patients. medRxiv. 2020.
28
Musolino AM, Supino MC, Buonsenso D, Papa RE, Chiurchiù S, et al. Lung ultrasound in the diagnosis and monitoring of 30 children with coronavirus disease 2019. Pediatr Pulmonol. 2021;56:1045-52.
29
Buonsenso D, Piano A, Raffaelli F, Bonadia N, de Gaetano Donati K, et al. Novel coronavirus disease-19 pnemoniae: a case report and potential applications during COVID-19 outbreak. Eur Rev Med Pharmacol Sci. 2020;24:2776-80.
30
Caro-Dominguez P, Shelmerdine SC, Toso S, Secinaro A, Toma P, et al. Thoracic imaging of coronavirus disease 2019 (COVID-19) in children: a series of 91 cases. Pediatr Radiol. 2020;50:1354-68.
31
Musolino AM, Supino MC, Buonsenso D, Ferro V, Valentini P, et al. Lung ultrasound in children with COVID-19: preliminary findings. Ultrasound Med Biol. 2020;46:2094-8.
32
Hizal M, Aykac K, Yayla BC, Yilmaz A, Altun D, et al. Diagnostic value of lung ultrasonography in children with COVID-19. Pediatr Pulmonol. 2021;56:1018-25.
33
Türe E, Korkmaz MF, Aksoy FD, Ceylan Demirbaş B, Menekşe B, et al. Point-of-care lung ultrasound findings in the pediatric emergency clinic during the COVID-19 pandemic. J Clin Ultrasound. 2021;49:85-90.
34
Feng X, Tao X, Zeng L, Wang WQ, Li G. [Application of pulmonary ultrasound in the diagnosis of COVID-19 pneumonia in neonates]. Zhonghua Er Ke Za Zhi. 2020;58:347-50.
35
Islam N, Ebrahimzadeh S, Salameh JP, Kazi S, Fabiano N, et al. Thoracic imaging tests for the diagnosis of COVID-19. Cochrane Database Syst Rev. 2021;3:CD013639.
36
Soldati G, Smargiassi A, Inchingolo R, Buonsenso D, Perrone T, et al. Is there a role for lung ultrasound during the COVID-19 pandemic? J Ultrasound Med. 2020;39:1459-62.
37
De Rose C, Inchingolo R, Smargiassi A, Zampino G, Valentini P, et al. How to Perform Pediatric Lung Ultrasound Examinations in the Time of COVID-19 J Ultrasound Med. 2020;39:2081-2.
38
Volpicelli G, Gargani L. Sonographic signs and patterns of COVID-19 pneumonia. Ultrasound J. 2020;12:22.
39
Sultan LR, Sehgal CM. A review of early experience in lung ultrasound in the diagnosis and management of COVID-19. Ultrasound in Med Biol. 2020;46:2530-45.
40
Yasukawa K, Minami T. Point-of-care lung ultrasound findings in patients with COVID-19 pneumonia. Am J Trop Med Hyg. 2020;102:1198-202.
41
Guitart C, Suárez R, Girona M, Bobillo-Perez S, Hernández L, et al. Lung ultrasound findings in pediatric patients with COVID-19. Eur J Pediatr. 2021;180:1117-23.
42
Peng QY, Wang XT, Zhang LN; Chinese Critical Care Ultrasound Study Group (CCUSG). Findings of lung ultrasonography of novel corona virus pneumonia during the 2019–2020 epidemic. Intensive Care Med. 2020;46:849-50.
43
Volpicelli G, Lamorte A, Villén T. What’s new in lung ultrasound during the COVID-19 pandemic. Intensive Care Med. 2020;46:1445-48.
44
Xia W, Shao J, Guo Y, Peng X, Li Z, et al. Clinical and CT features in pediatric patients with COVID-19 infection: Different points from adults. Pediatr Pulmonol. 2020;55:1169-74.
45
Duan YN, Zhu YQ, Tang LL, Qin J. CT features of novel coronavirus pneumonia (COVID-19) in children. Eur Radiol. 2020;30:4427-33.
