LUNG ULTRASOUND IN NEONATES WITH COVID-19 PNEUMONIA – THE START OF A NEW ERA

OBJECTIVES: Newborns with SARS-CoV-2 infection that developed respiratory symptoms are a special category of patients, due to the fact that irradiating imaging tools are not recommended at their age. Because of their high cellular division rate, the X-ray and computer tomography scans should be avoided. The aim of this paper is to investigate the relevance of lung ultrasound (LU) in surveillance of neonates with SARS-CoV-2 infection. MATERIALS: In our study we searched PubMed, ScienceDirect and Embase databases based on the following keyword: ‘newborn’, ‘neonate’, ‘COVID-19’, ‘sonography’, ‘lung ultrasound’. The found articles were selected using inclusion and exclusion criteria, such as: lung ultrasound as diagnostic tool, newborns, neonates and <28 days of life as population of interest and COVID-19 pneumonia as pathology criteria. Moreover, we analysed a group of 11 patients with infection who was admitted at ‘Pius Brinzeu’ County Emergency Clinical Hospital at Neonatology Department. RESULTS: From the total of articles, we selected 8 of them, based on the inclusion and exclusion criteria, and we analysed their results. After that, we compared their resulted data with the ultrasound findings from our evaluated newborns. The main changes found using LU include decreasing to disappearing physiological A-lines, rare or confluent B-lines, subpleural consolidations, and pleura abnormalities such as thickening and irregularities. Furthermore, the severity of lung injuries was analysed based on a 12-area score. CONCLUSIONS: Regarding neonates, lung ultrasound is an important tool in the evaluation of lung injuries associated with this infection, being demonstrated in several reviewed studies. Also, this imaging technique come with the benefits of being a repetitive, radiation-free, easy-to-use and reliable procedure for observing the impact and surveillance of COVID-19 on the neonates’ respiratory system. This imaging method was proved useful also in other respiratory diseases and could eventually be an indispensable item in the management and monitoring of newborns with respiratory infections, contouring new horizons in using it.