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Published on: December 19, 2020
Relationship of chest computed tomography score with disease severity and laboratory values in children with COVID-19
Ceren Çetin1, Ayse Karaaslan1, Yasemin Akın2
1Department of Pediatric Infectious Diseases, University of Health Sciences, Kartal Dr Lutfi Kırdar City Hospital, Istanbul, Turkey.
Insights
Chest CT scores effectively assess COVID-19 severity in children, correlating with laboratory markers like d-dimer and lymphocyte counts. This tool aids in evaluating disease progression and clinical outcomes in pediatric patients.
Area of Science:
- Pediatric Radiology
- Infectious Diseases
- Medical Imaging
Background:
- Chest computed tomography (CT) scoring is established for adult COVID-19 but understudied in pediatric cases.
- Accurate assessment of disease severity in children with COVID-19 is crucial for effective management.
Purpose of the Study:
- To evaluate the relationship between chest CT scores and disease severity in pediatric COVID-19 patients.
- To determine the correlation of chest CT scores with key laboratory parameters in children with COVID-19.
Main Methods:
- Seventy-six pediatric patients with confirmed COVID-19 underwent chest CT on admission.
- A five-lobar chest CT scoring system was employed, quantifying anatomical involvement (0-5 per lobe, total 0-25).
- Correlation analysis was performed between total CT scores, lobar scores, and laboratory markers (ALT, D-dimer, lymphocyte count, leukocyte count).
Main Results:
- Total chest CT score positively correlated with alanine aminotransferase and D-dimer, and negatively with lymphocyte count.
- Receiver operating characteristic analysis showed an area under the curve of 0.99 for total CT score at a cut-off of 2 for severe disease (95% sensitivity, 96% specificity).
- Specific lobar CT scores correlated with individual laboratory parameters, including lymphocyte count, D-dimer, alanine aminotransferase, and leukocyte count.
Conclusions:
- Chest CT scores demonstrate a significant relationship with COVID-19 severity and laboratory findings in children.
- Chest CT scoring is a valuable tool for assessing disease severity in pediatric COVID-19 cases.
- This scoring system can play an important role in the clinical practice for managing pediatric COVID-19 patients.
Aim:
Although chest computed tomography (CT) score has been well evaluated in adult coronavirus disease (COVID-19), its use in paediatric cases is insufficiently studied. Our aim is to evaluate the relationship of chest CT score with disease severity and laboratory parameters.
Methods:
Seventy-six paediatric patients with confirmed COVID-19 and chest CT evaluation on admission have been included in this study. Chest CT score was calculated for each of the five lobes considering the extent of anatomical involvement, as follows: 0: 0%; 1: <5%; 2: 5%-25%; 3: 26%-50%; 4: 51%-75% and 5: >75%. The resulting total CT score was the sum of each individual lobar score; the range was between 0 and 25.
Results:
Total chest CT score was found to be positively correlated with alanine aminotransferase and d-dimer, and negatively correlated with lymphocyte count. In receiver operating characteristic analysis, total chest CT score had area under the curve 0.99 (95% confidence interval, 0.98-1.00) at cut-off 2 with 95% sensitivity and 96% specificity for the severe disease. Furthermore, in-depth analysis of lobar CT scores showed a correlation between left upper lobe with lymphocyte count, left lower lobe with d-dimer, right middle and lower lobes with alanine aminotransferase and right upper lobe with leukocyte count.
Conclusions:
There is a significant relationship between chest CT score and COVID-19 severity and laboratory findings in children. This suggests that chest CT scores can be used to assess the severity of the disease and can play an important role in paediatric clinical practice.
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