Lung Ultrasound in Children with Respiratory Tract Infections: Viral, Bacterial or COVID-19? A Narrative Review

Sigmund Kharasch,¹ Nicole M Duggan,² Ari R Cohen,³ Hamid Shokoohi<sup>4

1</sup>Division of Pediatric Emergency Medicine, Division of Emergency Ultrasound, Department of Pediatrics, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA; ²Harvard Affiliated Emergency Medicine Residency Program, Harvard Medical School, Boston, MA, USA; ³Division of Pediatric Emergency Medicine, Department of Emergency Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA; ⁴Division of Emergency Ultrasound, Department of Emergency Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA

Correspondence: Hamid Shokoohi Email [email protected]

Abstract: Respiratory tract infections (RTIs) are common complaints among patients presenting to the pediatric emergency department. In the diagnostic assessment of children with RTIs, many patients ultimately undergo imaging studies for further evaluation. Point-of-care lung ultrasound (LUS) can be used safely and with a high degree of accuracy in differentiating etiologies of RTIs in pediatric patients. Ultrasonographical features such as an irregular pleural line, subpleural consolidations, focal and lobar consolidation and signs of interstitial involvement can be used to distinguish between several pathologies. This work offers a comprehensive overview of pediatric LUS in cases of the most common pediatric RTIs including bacterial and viral pneumonia, bronchiolitis, and COVID-19.

Keywords: lung, ultrasound, pediatric, pneumonia, COVID-19, bronchiolitis