Pediatric chest X-rays during the COVID-19 pandemic

Area of Science:

• Pediatric infectious diseases
• Radiology
• Epidemiology

Background:

• The emergence of COVID-19 (Coronavirus Disease 2019) presented a global health challenge, particularly concerning its impact on pediatric populations.
• Limited data existed on the specific radiologic findings in children diagnosed with COVID-19, despite chest X-rays being a common initial diagnostic tool for respiratory infections.

Purpose of the Study:

• To characterize the clinical, laboratory, and chest X-ray findings in pediatric patients presenting with respiratory infection symptoms.
• To determine the prevalence of COVID-19 compared to other respiratory infections in this cohort.
• To detail the specific radiological manifestations observed in pediatric COVID-19 cases.

Main Methods:

• A cross-sectional observational study was conducted on pediatric patients (infants to 16 years) presenting with respiratory symptoms (fever, cough, etc.) requiring chest X-rays.
• Data collected included clinical presentation, family history of COVID-19, and microbiological analyses (including SARS-CoV-2 PCR for a subset of patients).
• Chest X-ray findings were systematically analyzed for abnormalities.

Main Results:

• Of 231 pediatric patients studied, 73.2% showed abnormalities on chest X-rays, with peribronchial thickening being the most frequent finding (57%).
• Only 6.3% (3 out of 47) of patients tested via PCR were positive for SARS-CoV-2, indicating COVID-19 was less common than other respiratory infections during the study period.
• Parenchymal consolidations occurred in 38.5% of patients, with ground-glass opacities and thickened interstitial lines observed less frequently.

Conclusions:

• COVID-19 and other respiratory infections co-existed in pediatric patients during March 2020.
• Chest X-ray findings in pediatric respiratory infections, including COVID-19, are often nonspecific and insufficient for definitive diagnosis.
• Pediatric COVID-19 cases generally presented with mild symptoms, rarely requiring hospitalization or mechanical ventilation, underscoring the importance of PCR testing even without clear epidemiological links.