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The lung ultrasound in children with SARS-COV 2 infection: a national multicenter prospective study
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  • Maria Supino,
  • Danilo Buonsenso,
  • Rino Agostiniani,
  • Laura Gori,
  • Vincenzo Tipo,
  • Rosa Morello,
  • Angelo Giovanni Delmonaco,
  • Raffaele Falsaperla,
  • Carlotta Biagi,
  • Salvatore Cazzato,
  • Alberto Villani,
  • Anna Maria Musolino,
  • Simona Scateni,
  • Valentina Ferro,
  • Barbara Scialanga,
  • Alessia Mesturino,
  • Elena Boccuzzi,
  • Carolina D'Anna,
  • Vittorio Romagnoli,
  • Silvia Marino,
  • Roberta Puxeddu,
  • Gaia Martelli,
  • Thaililja Gagliardo,
  • Manuel Murciano,
  • Federica Pellizzoni
Maria Supino
Ospedale Pediatrico Bambino Gesu

Corresponding Author:mariachiarasupino@gmail.com

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Danilo Buonsenso
Policlinico Universitario Agostino Gemelli Dipartimento Scienze della Salute della Donna e del Bambino
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Rino Agostiniani
Azienda USL Toscana centro Sede di Pistoia
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Laura Gori
Ospedale Santa Chiara
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Vincenzo Tipo
Azienda Ospedaliera di Rilievo Nazionale Santobono Pausilipon
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Rosa Morello
Policlinico Universitario Agostino Gemelli Dipartimento Scienze della Salute della Donna e del Bambino
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Angelo Giovanni Delmonaco
Azienda Ospedaliero Universitaria Citta della Salute e della Scienza di Torino
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Raffaele Falsaperla
Azienda Sanitaria Provinciale di Catania
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Carlotta Biagi
Azienda Ospedaliero Universitaria Ospedali Riuniti di Ancona Umberto I G M Lancisi G Salesi
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Salvatore Cazzato
IRCCS Azienda Ospedaliero-Universitaria di Bologna
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Alberto Villani
Ospedale Pediatrico Bambino Gesu
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Anna Maria Musolino
Ospedale Pediatrico Bambino Gesu
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Simona Scateni
Ospedale Pediatrico Bambino Gesu
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Valentina Ferro
Ospedale Pediatrico Bambino Gesu
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Barbara Scialanga
Ospedale Pediatrico Bambino Gesu
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Alessia Mesturino
Ospedale Pediatrico Bambino Gesu
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Elena Boccuzzi
Ospedale Pediatrico Bambino Gesu
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Carolina D'Anna
Azienda Ospedaliera di Rilievo Nazionale Santobono Pausilipon
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Vittorio Romagnoli
IRCCS Azienda Ospedaliero-Universitaria di Bologna
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Silvia Marino
Azienda Sanitaria Provinciale di Catania
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Roberta Puxeddu
Azienda USL Toscana centro Sede di Pistoia
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Gaia Martelli
IRCCS Azienda Ospedaliero-Universitaria di Bologna
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Thaililja Gagliardo
Azienda Ospedaliera di Rilievo Nazionale Santobono Pausilipon
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Manuel Murciano
Ospedale Pediatrico Bambino Gesu
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Federica Pellizzoni
Universita Vita Salute San Raffaele
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Abstract

Covid-19 causedhospitalizations, 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 (LUS) in children with Covid-19. We enrolled children between 1 month and 18 years of age diagnosed with SARS-CoV2 infection and whounderwenta lung ultrasound within 6 hours from firstmedical evaluation. A total of 213 children were enrolled, 51.6%were male, median age was2 years and 5 months (IQR 4mm- 11 yearsand4 months).One hundred and fortyeight (69.4%) children were admitted in hospital, 9 (6.1%) in pediatric intensive care unit.We found an inverse correlation between the LUS score and the oxygen saturationatthe clinical evaluation (r = −0.16; p = 0.019). Moreover, LUS scores were significantly higher in patients requiring oxygen supplementation (8 (IQR 3 - 19) vs 2 (IQR 0 - 4); p= 0.001). Among LUS pathological findings, irregular pleural line, sub-pleural consolidations and pleural effusions were significantly more frequentin patients whoneeded oxygen supplementation (p = 0.007; p = 0.006 andp = 0.001, respectively). This multicentric study confirmed that LUS is able to detect Covid-19 low respiratory tract involvement, which is characterized by pleural line irregularities, vertical artifacts and subpleural consolidations. Notably, children with higher LUS score have an higher risk of hospitalization or need for oxygen supplementation, supporting LUS as a valid and safe point-of-care first level tool for the clinical evaluation of children with Covid-19.