In Brief | Pulmonary Dysfunction after Pediatric COVID-19 

Originally published In Radiology: March 2023

While there is increasing knowledge regarding the multi-organ damage caused by COVID-19 post-acute infection, these sequelae in children and adolescents remain relatively under-researched. Concerns have been raised regarding these ongoing effects, particularly thrombotic state, microangiopathy and inflammation. As the primary site of SARS-COV-2 infection, the lung is of particular concern.

According to the researchers of this paper Hess et al, at even "…3 months after infection, angiographic imaging of pulmonary microcirculation has revealed widespread microangiopathy in over 65% of patients." ¹ 

However, invasive imaging techniques are not recommended in children. Furthermore, they are of limited value given that lung parenchymal changes resulting from COVID-19 are less conspicuous and less pronounced in the paediatric population. A more precise characterization of pulmonary manifestations following SARS-CoV-2 infection is needed to assist in identifying possible lingering pulmonary effects in this population.

This study aimed to characterize morphological and functional changes in lung parenchyma using low-field MRI in children and adolescents experiencing post-COVID-19 conditions relative to their healthy counterparts. 

The prospective clinical trial included:

• Fifty-four children and adolescents who were previously infected with SARS-CoV-2.
• The mean age was 11 (SD +/- 3 years), and 56% were boys. 
• 29 (54%) of these patients had recovered from the infection, while 25 (46%) were diagnosed with long COVID-19 at enrolment.  
• Nine healthy controls were chosen, the average age of whom was 10 ( SD +/- 3 years), and 78% were boys.

The primary outcome measure was the incidence of morphological changes observed via MRI, with secondary outcomes encompassing functional proton ventilation and perfusion parameters derived from MRI data.

The following was recorded:

• The ventilation-perfusion (V/Q) match was higher in the healthy control group (81%,+/- 6.1) compared with the recovered COVID group (61%,+/19 ) and those with long COVID: (6% +/ 20)

• The V/Q match was lower in patients infected for less than 180 days before the study's commencement than in the never-infected healthy controls. 

The field-strength MRI confirmed persistent pulmonary dysfunction in children and adolescents who had recovered from COVID-19 and in individuals experiencing long-term COVID.

The findings highlight the case for the adoption of these imaging techniques into the routine care of these children.

 

Access the original article
 

1. Heiss, R., Tan, L., Schmidt, S., Regensburger, A. P., Ewert, F., Mammadova, D., Buehler, A., Vogel-Claussen, J., Voskrebenzev, A., Rauh, M., Rompel, O., Nagel, A. M., Lévy, S., Bickelhaupt, S., May, M. S., Uder, M., Metzler, M., Trollmann, R., Woelfle, J., Wagner, A. L., … Knieling, F. (2023). Pulmonary Dysfunction after Pediatric COVID-19. Radiology, 306(3), e221250. https://doi.org/10.1148/radiol.221250

 Back to top

Disclaimer
This article is compiled from a variety of resources researched and compiled by the contributor. It is in no way presented as an original work.  Every effort has been made to correctly attribute quotes and content. Where possible all information has been independently verified. The Medical Education Network bears no responsibility for any inaccuracies which may occur from the use of third-party sources. If you have any queries regarding this article contact us 

Fact-checking Policy
The Medical Education Network makes every effort to review and fact-check the articles used as source material in our summaries and original material. We have strict guidelines in relation to the publications we use as our source data, favouring peer-reviewed research wherever possible. Every effort is made to ensure that the information contained here is an accurate reflection of the original material. Should you find inaccuracies, out of date content or have any additional issues with our articles, please make use of the contact us form to notify us.