CT Features of Coronavirus Disease (COVID-19) in 30 Pediatric Patients

OBJECTIVE. The purpose of this study is to characterize the CT findings of 30 children from mainland China who had laboratory-confirmed coronavirus disease (COVID-19). Although recent American College of Radiology recommendations assert that CT should not be used as a screening or diagnostic tool for patients with suspected COVID-19, radiologists should be familiar with the imaging appearance of this disease to identify its presence in patients undergoing CT for other reasons. MATERIALS AND METHODS. We retrospectively reviewed the CT findings and clinical symptoms of 30 pediatric patients with laboratory-confirmed COVID-19 who were seen at six centers in China from January 23, 2020, to February 8, 2020. Patient age ranged from 10 months to 18 years. Patients older than 18 years of age or those without chest CT examinations were excluded. Two cardiothoracic radiologists and a cardiothoracic imaging fellow characterized and scored the extent of lung involvement. Cohen kappa coefficient was used to calculate interobserver agreement between the readers. RESULTS. Among children, CT findings were often negative (77%). Positive CT findings seen in children included ground-glass opacities with a peripheral lung distribution, a crazy paving pattern, and the halo and reverse halo signs. There was a correlation between increasing age and increasing severity of findings, consistent with reported symptomatology in children. Eleven of 30 patients (37%) underwent follow-up chest CT, with 10 of 11 examinations (91%) showing no change, raising questions about the utility of CT in the diagnosis and management of COVID-19 in children. CONCLUSION. The present study describes the chest CT findings encountered in children with COVID-19 and questions the utility of CT in the diagnosis and management of pediatric patients.