Radiologists Identify Abnormal Ultrasound Findings In Children With Post-COVID-19 Inflammatory Condition

A multisystem hyperinflammatory condition has recently emerged in children in association with prior exposure to SARS-CoV-2, according to a new case series.

The study examines the spectrum of imaging findings in children with post-COVID-19 inflammatory condition called multisystem inflammatory syndrome in Children (MIS-C) in the U.S.

Key imaging findings include:

• Airway inflammation
• Rapid development of pulmonary edema
• Coronary artery aneurysms
• Extensive intra-abdominal inflammatory changes

In April, there was a surge in the number of pediatric cases with multi-system hyperinflammatory syndrome admitted to Evelina London Children’s Hospital in London.

The children reportedly have several symptoms including fever, headaches, skin rashes, abdominal pain and conjunctivitis. The clinical features alongside the lab findings share some similarities to those of Kawasaki disease.

“Our hospital saw an unprecedented cluster of children presenting with MIS-C, a new hyperinflammatory syndrome in children related to the current COVID-19 pandemic -- the recognition of which led to a national alert," Science Daily quoted the study's lead author, Shema Hameed, M.B.B.S., consultant pediatric radiologist at Evelina London Children's Hospital.

The Study:

The experts conducted a retrospective review of the clinical, laboratory as well as imaging findings of the first 35 pediatric patients under 17 years of age admitted to the hospital that met the case definition of MIS-C.

Key Findings of the study:

• 94% of the children presented with fever
• 86% of them had gastrointestinal symptoms including abdominal pain, vomiting, and diarrhea
• 37% had skin rashes and 26% had conjunctivitis
• 69% needed intensive care, 20% required mechanical ventilation and 57% required inotropic support
• All of them had abnormal WBC counts
• 19 X-rays were abnormal and the most common finding was bronchial thickening
• Chest CT revealed collapsed lung with pleural effusions and build-up of fluid in the outer membranes of the lungs
• Abdominal ultrasounds revealed inflammatory changes within the right iliac fossa, bowel wall thickening, and mesenteric fat stranding alongside lymphadenopathy.

Pediatric radiologists are interested in these emerging patterns of imaging findings observed in these pediatric COVID-19 patients.

The researchers intend to bring these findings to the attention of the wider radiological community and advise that future studies should include a larger group of patients.