Short report - Usefulness of point-of-care ultrasound in pediatric SARS-CoV-2 infection

Area of Science:

• Pediatric Critical Care Medicine
• Infectious Diseases
• Medical Imaging

Background:

• SARS-CoV-2 infection is less common in children than adults, but some require hospitalization and Pediatric Intensive Care Unit (PICU) admission.
• Conventional diagnostic methods may miss key findings in pediatric COVID-19 patients.

Purpose of the Study:

• To share experiences using Point-of-Care Ultrasound (POCUS) in managing pediatric patients with SARS-CoV-2 infection.
• To highlight the utility of POCUS in identifying effusions and other relevant findings.

Main Methods:

• Point-of-Care Ultrasound (POCUS) was utilized for bedside assessment of pediatric COVID-19 patients.
• Lung and echocardiographic POCUS examinations were performed.
• POCUS was used for optimizing positive end-expiratory pressure (PEEP), confirming endotracheal tube placement, assessing volume status, cardiac function, and neuro-monitoring.

Main Results:

• All pediatric COVID-19 patients in the study presented with pleural and pericardial effusions, detected by POCUS.
• These effusions were present despite adequate urinary output and before fluid resuscitation, and would likely have been missed by portable chest X-rays.
• Other POCUS findings included consolidations and coalescent B-line patterns.
• No cross-infection occurred during POCUS procedures.

Conclusions:

• POCUS is a valuable tool for managing pediatric patients with SARS-CoV-2 infection.
• Pleural and pericardial effusions are frequent in pediatric COVID-19 and can be readily detected by lung and echocardiographic POCUS.
• POCUS aids in comprehensive patient assessment, including respiratory mechanics, hemodynamics, and neurological status, without increasing infection risk.