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Updated: Dec 9, 2025
Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
Published on: March 6, 2019
Lung point-of-care (POCUS) ultrasound in a pediatric COVID-19 case
Prisca M Alilio1, Natalie E Ebeling-Koning1, Kevin R Roth1
1Lehigh Valley Health Network, Department of Emergency and Hospital Medicine/USF Morsani College of Medicine, Cedar Crest Boulevard & I-78, Allentown, PA, USA 18103.
Insights
Point-of-care ultrasound (POCUS) rapidly assessed lung pathology in a pediatric COVID-19 case. This bedside imaging technique is efficient for evaluating SARS-CoV-2 related pneumonia in children.
Area of Science:
- Pediatric Medicine
- Infectious Diseases
- Medical Imaging
Background:
- Coronavirus disease 2019 (COVID-19) was declared a pandemic in February 2020.
- Resource adequacy for treating COVID-19 cases is a significant public health concern in the United States.
- Limited literature exists on the use of lung POCUS in pediatric patients with SARS-CoV-2.
Observation:
- A 9-year-old obese male presented with severe COVID-19 symptoms including respiratory distress and fever.
- Diagnostic workup revealed COVID-19, high venous thromboembolism risk (elevated d-dimer), and significant lung pathology.
- Lung point-of-care ultrasound (POCUS) demonstrated pleural thickening, consolidation, and B lines.
Findings:
- Chest X-ray confirmed bilateral ground glass opacities and interstitial prominence, indicative of viral pneumonia.
- Lung POCUS provided rapid and adequate imaging of lung pathology in this pediatric COVID-19 case.
- The patient's presentation underscores the potential severity of COVID-19 in pediatric populations.
Implications:
- Lung POCUS can serve as an efficient bedside imaging modality for assessing pediatric COVID-19.
- This case contributes to the limited literature on lung POCUS utility in pediatric SARS-CoV-2 infections.
- Early and accurate lung assessment is crucial for managing pediatric COVID-19 patients.
Abstract:
The World Health Organization categorized coronavirus disease 2019 (COVID-19) as a pandemic due to its high contagion rate and widespread infectivity in February 2020. In the United States, one of the public health concerns is the adequacy of resources to treat infected cases. We describe a case of a previously well, 9-year-old obese boy who presented to the emergency department with shortness of breath, fever, abdominal pain, and cough with chest pain. He was diagnosed with COVID-19 through significant family contact, confirmed by polymerase chain reaction and found to be at high risk of venous thromboembolism due to abnormal d-dimer. Lung point-of-care ultrasound (POCUS) in the emergency department observed significant lung pathology, including pleural thickening, consolidation, and B lines. A chest X-ray found bilateral ground glass opacities and interstitial prominences consistent with viral pneumonia. Our case suggests that lung POCUS can provide adequate and rapid imaging to assess lung pathology of COVID-19 in a pediatric patient. As there is limited literature on use of lung POCUS in pediatric patients infected with SARS-CoV-2, our case emphasizes its function as a potentially efficient modality in bedside assessment.
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