ORIGINAL ARTICLE   

Journal of Radiological Review 2022 March;9(1):3-8

DOI: 10.23736/S2723-9284.21.00169-6

Copyright © 2022 EDIZIONI MINERVA MEDICA

lingua: Inglese

COVID-related multisystem inflammatory syndrome in children: intestinal involvement and ultrasound findings

Sonia TAMASI ¹, Iolanda CAPALDO ² ✉, Stefano CALABRESE ², Carolina D’ANNA ¹, Rosanna MAMONE ¹, Anna M. GIUGLIANO ¹, Vincenzo TIPO ¹, Arturo BRUNETTI ², Massimo ZECCOLINI ¹

¹ AORN Santobono-Pausilipon, Naples, Italy; ² Federico II University Hospital, Naples, Italy

BACKGROUND: Multi-system inflammatory syndrome in children (MIS-C) is a new syndrome associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection that has been reported in children in increasing numbers. The aim of our study was to describe abdominal imaging findings in these children focusing on ultrasound examination.
METHODS: We retrospectively reviewed imaging studies and medical records of 21 patients (age range, 3 months-12 years) admitted with Multisystem Inflammatory Syndrome in Children in December 2020.
RESULTS: Twenty-one patients were included in this study. All patients (21/21) presented with fever and positive serologic findings for SARS-CoV-2. Only one tested negative on RT-PCR and antibody results. Other patients presented signs and symptoms including abdominal pain (17/21; 80%), diarrhea (10/21; 48%) and vomiting (4/21; 19%), rash (5/21; 24%), conjunctivitis (5/21; 24%). All patients underwent an abdominal ultrasound examination: fifteen children (71%) showed cecal and distal ileal wall thickening and nine (43%) showed appendicitis as well. Fourteen patients showed mesenteric fat stranding, lymphadenopathy and free abdominal fluid (66%). Hepatomegaly and augmented echogenicity of liver parenchyma was observed in six children (28%). Only one child showed gallbladder wall thickening. Two children (10%) showed echogenic kidneys and loss of cortico-medullary differentiation. Eight patients showed urinary bladder wall thickening (38%). Only one death occurred.
CONCLUSIONS: COVID-19 related MIS-C is characterized by gastrointestinal symptoms with rapid deterioration of the patient’s status. Family pediatricians, emergency doctors and radiologists should be aware of the constellation of nonspecific imaging findings, which when combined with the clinical presentation and a history of exposure to SARS-CoV-2 should suggest MIS-C.

KEY WORDS: Systemic inflammatory response syndrome; Child; COVID-19; SARS-CoV-2; Ultrasonography