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Introduction: Children showed a lower prevalence of severe respiratory symptoms in acute COVID-19 infection, differently from adults. A recent study among adult patients affected by COVID-19 revealed lung function abnormality. Until now there has been no report regarding pulmonary function in COVID-19 children. Spirometry is not recommended during acute COVID-19 infection. SLP is a non-contact technology which has been used in children with asthma or neuromuscular disease. It evaluates thoracoabdominal wall movements to measure lung volumes. Aims and Objectives: We aimed to investigate SLP in children with COVID-19 acute respiratory symptoms and to describe their pulmonary function. Methods: 7 COVID-19 children with acute respiratory symptoms admitted to the Pediatric Department of Buzzi Children Hospital, Milan, Italy, were evaluated with SLP from May 2020 to January 2021. T-test was used to compare SLP parameters of COVID-19 group with healthy controls and children affected by pneumonia, before the pandemic. Results: Patients’age ranged from 18 months to 16 years. IE50 median value in COVID-19 children was 1.61± 0.30 with a significant difference from healthy controls (IE50 1.22±0.27; p 0.05). Conclusions: This study shows an increased IE50 value resulting in mild deficiency of lung function among children with acute COVID-19 respiratory symptoms, with a difference from controls. SLP does not require contact with patients and offers a proper solution for obtaining lung function parameters during a pandemic.

Background: VOCs originate from metabolic pathophysiological processes at respiratory and systemic level. VOCs pattern has previously been analysed with E-nose on exhaled air; in CF it distinguished P.aeruginosa and A.fumigatus colonization. Aim: to evaluate exhaled VOCs pattern with E-nose (Cyranose320®)in HC and in CF pts; to compare exhaled VOCs in stable CF pts (StCF) and in pts with respiratory exacerbation (ExCF). Methods: a cross-sectional experimental study was approved by Verona Ethic Committee. Spirometry, N2multiple breath washout (MBW) and exhaled air collection were performed in 29 CF pts (age 12.56 ± 4.08; 23 StCF, 6 ExCF) and 15 HC (age 13.36 ±4.13). VOCs analysis was performed with Cyranose320®. The output data underwent multivariate analysis and Principal Component Analysis (PCA). Results: A number of E-nose sensors (S6-8, S10, S12, S21, S27, S28) significantly distinguished between HC and CF pts; also, StCF could be discriminated from ExCf (S6-8, S10, S12, S21, S27). For sensors distinguishing between HC and CF pts, AUC of ROC was more than accurate for S12 (0.85), good for S6-7, S21, S27 (0.73-0.76). PCA identified PC10, PC1, PC7 and PC2, which proved the best PC in predicting between HC and CF subsets. Spirometry distinguished HC from ExCF, but not from St CF, whereas N2MBW distinguished also StCF from HC. Conclusion: E-nose analysis of exhaled air samples distinguished HC from CF pts, and among CF pts, StCF from ExCF. N2MBW distinguished all 3 subsets, whereas spirometry only distinguished ExCF from HC. E-nose is a promising tool for clinical and research setting.

Background: Chronic loss of lung function was described in SCD patients (pts), even if not fully characterized in children. Aim: to explore lung function in children with SCD, through the assessment of resistance measurements and ventilation patterns. Methods: spirometry, FOT, IOS and N2MBW were performed in 15 stable pediatric pts with SCD, F 46.67%, Caucasian 13.33%, aged 12 ±3.8 years, mean HbS 66.36 ±17.44, ICS/LABA therapy in 20%, ICS therapy in 13.33%. Results: A mild restrictive pattern was found (FEV1 86.96 ±15.91 %pred, FVC 75.47 ±26.62%pred, MMEF75-25 86.76 ±21%pred). Lung Clearance Index (LCI) 2.5% was elevated (7.91 ±2.26, 120%pred), as well as normalized acinar slope index Sacin (0.12 ±0.14, 220%pred). IOS measured an increase in resistance (R) at 5 Hz (119.37 [101.68-137.79] %pred) while FOT showed an increase in R at 8 Hz (118.05 [101.87-140.29] %pred) and decrease in reactance(X) at 8 Hz. Expiratory R inversely correlated with MMEF75-25 (r -0.6, p 0.03). Pts Conclusions: IOS and FOT may help to depict and monitor early lung function changes in children with SCD. N2MBW did not correlate here with spirometry, FOT or IOS, thus it may be considered to add a novel and complementary insight in functional status of children with SCD, through the representation of ventilation inhomogeneity.

Introduction: Structured Light Plethysmography(SLP) is a new non-invasive method that records real-time images of chest wall movement,using a grid of light,tracked by a digital vision system of 2 high-speed cameras. Chest movement is analyzed showing the breathing pattern of the patient,the tidal breathing flow/volume graph to point out inspiratory or expiratory flow limitation,and regional subdivision to assessed abnormal contribution to the tidal volume of the different regions of the chest. It doesn9t require patient collaboration like spirometry;so it could be an alternative to evaluate pre-school children. Aims and objectives: Use SLP to evaluate the degree of expiratory flow limitation in asthmatic children. Methods: We evaluate 27 asthmatic children:10 with well-controlled asthma (GroupA),17 during asthma exacerbation(GroupB): every patient underwent SLP evaluation,and when it was possible also a spirometry was collected. We considered at SLP exam IE50:the ratio of inspiratory flow at 50% of tidal volume (VT) to expiratory flow at 50% of VT;value greater than 1.2 suggest expiratory flow limitation. Results: Group A showed greater value of FEV1 [median(LQ-UQ)% pred] [106.1(103.3-116.8)vs 69.7(57.50-82.35)p=0.0002]at spirometry; similarly IE50 was lower in Group A [1.16(0.99-1.54)vs 1.40(1.25-1.72)p=0.026] Conclusions: IE50 showed expiratory flow limitation in children during asthma exacerbation and a difference with well-controlled asthma children; this data are coherent with spirometric data collected. SLP is non-invasive and doesn9t need collaboration so it could represent a way to study the degree of obstruction in pre-school asthmatic children.