No abstract

Background Lung ultrasound (LUS) has been successfully used in the diagnosis of different pulmonary diseases. Present study design to determine the diagnostic value of LUS in the evaluation of children with novel coronavirus disease 2019 (COVID‐19). Methods and Objectives Prospective multicenter study, 40 children with confirmed COVID‐19 were included. LUS was performed to all patients at admission. The chest X‐ray and computed tomography (CT) were performed according to the decision of the primary physicians. LUS results were compared with chest X‐ray and CT findings and diagnostic performance was determined. Results Of the 40 children median (range) was 10.5 (0.4–17.8) years. Chest X‐ray and LUS were performed on all and chest CT was performed on 28 (70%) patients at the time of diagnosis. Sixteen (40%) patients had no apparent chest CT abnormalities suggestive of COVID‐19, whereas 12 (30%) had abnormalities. LUS confirmed the diagnosis of pulmonary involvement in 10 of 12 patients with positive CT findings. LUS demonstrated normal lung patterns among 15 of 16 patients who had normal CT features. The sensitivity and the area under the receiver operating characteristics (ROC) curve (area under the ROC curve) identified by the chest X‐ray and LUS tests were compared and statistically significantly different (McNemar's test: p = .016 and p = .001 respectively) detected. Chest X‐ray displayed false‐negative results for pulmonary involvement in 75% whereas for LUS it was 16.7%. Conclusions LUS might be a useful tool in the diagnostic steps of children with COVID‐19. A reduction in chest CT assessments may be possible when LUS is used in the initial diagnostic steps for these children.

No abstract

There are concerns about the possibility of SARS-CoV-2 reinfection and recently, a patient with SARS-CoV-2 re-infection (or COVID-19) confirmed by epidemiological, clinical, serological and genomic analyses have been published. We have noticed another patient with SARS-CoV-2 re-infection based on clinical and laboratory studies: A 23-year-old woman presented to her hospital with fever (39°C), chills, fatigue, cough, headache, sore throat, muscle and joint pain on April 9, 2020. On examination, oropharynx was mildly hyperemic, and chest auscultation was normal. SARS-CoV-2 PCR from nasopharyngeal specimen was ordered. She was given isotonic saline and acetaminophen and prescribed azithromycin and acetaminophen and sent home for isolation. SARS-CoV-2 PCR was reported positive and she was given hydroxychloroquine for five days. She improved in 10 days and PCR studies on April 22, and April 27 remained negative. On 4 August 2020, she was re-admitted with fever (38.7°C), chills, fatigue, loss of appetite, taste and smell loss, muscle and joint pain. On examination, oropharynx and chest auscultation were normal. SARS-CoV-2 PCR was reported positive and she was prescribed hydroxychloroquine, acetaminophen and sent home for isolation again. She improved in one week (taste-smell loss improved in 10 days) and on follow-up visit after 14 days, she was doing well. PCR was negative on 17 August 2020. Her anti-SARS-CoV-2 antibodies were negative on 17 August 2020 and slightly positive (2.14 signal-to-cutoff) on 29 August 2020. Previous report from To et al. [Clin Infect Dis. 2020;ciaa1275. doi:10.1093/cid/ciaa1275] showed that viral genomes from first and second episodes belonged to different clades/lineages. They described second episode of asymptomatic infection occurred 142 day after the first symptomatic one. Our patient is the first report, describing two symptomatic episodes 116 days apart. We conclude that as the patients recovered from COVID-19 increases, increased awareness may delineate the characteristics of re-infection.

No abstract