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Chest imaging for COVID-19: a single-center comparative results in pediatric patients
H Nursun Özcan1, Yasemin Özsürekci2, Berna Oğuz1
1Departments of Pediatric Radiology, Hacettepe University Faculty of Medicine Ankara, Turkey.
Insights
Chest CT sensitivity for pediatric COVID-19 is 78.26%, though chest X-ray is less sensitive. Combining imaging with pathogen detection offers a prompt diagnostic protocol for children.
Area of Science:
- Pediatric Radiology
- Infectious Diseases
- Medical Imaging
Background:
- Chest computed tomography (CT) is crucial for adult COVID-19 diagnosis.
- Limited comparative studies exist for pediatric viral infections.
- This study compares pediatric COVID-19 imaging with other viral infections.
Purpose of the Study:
- To compare imaging findings in pediatric COVID-19 patients versus other viral infections.
- To assess the association between radiological and laboratory findings in pediatric COVID-19.
- To evaluate the diagnostic utility of chest X-ray and CT in children with COVID-19.
Main Methods:
- Enrolled 79 children (<18 years) with COVID-19 confirmed by RT-PCR or antibody testing.
- Obtained plain chest X-rays for all subjects.
- Performed non-contrast chest CT for symptomatic patients.
Main Results:
- Compared 75 COVID-19 patients with 4 patients having other viral infections (adenovirus, rhinovirus, parainfluenza, RSV).
- Chest X-ray sensitivity was 10.67% compared to RT-PCR.
- Chest CT sensitivity was 78.26% with a 21.7% false-negative rate; 5/23 CTs were normal, 9 showed only nodules.
Conclusions:
- Chest CT sensitivity in children with COVID-19 was found to be low.
- No significant correlations were found between radiological parameters and lymphopenia.
- A combined approach of clinical follow-up, pathogen detection, and chest CT is suggested for symptomatic pediatric COVID-19 cases.
Background:
Chest computed tomography (CT) appears to be an important radiological modality for the diagnosis of COVID-19 in adults. Studies comparing the findings of such children with those of other viral infections have not been reported either. The aim of this study was to present comparative imaging findings of 75 pediatric COVID-19 patients and four patients with other viral upper respiratory tract infections. We also aimed to demonstrate the possible association between the radiological and laboratory findings in the COVID group.
Methods:
From 11 March 2020 to 20 June 2020, 79 children (aged < 18 years) were enrolled. COVID-19 was detected by RT-PCR or antibody testing. A plain chest X-ray was obtained from all subjects. Non-contrast chest CT was performed for symptomatic patients.
Results:
Seventy-five patients had COVID-19 and 4 were infected with other pathogens i.e. adenovirus, rhinovirus, parainfluenza virus B, respiratory syncytial virus. The ages of the patients (36 M, 43 F) ranged from 7 months to 17 years old. The sensitivity of chest X-ray (as compared to RT-PCR) was 10.67% (95 CI%: 4.72 - 19.94%). From 23 chest CT`s five of them were normal and nine of them had only nodules ( < 5mm). The sensitivity of CT was 78.26% (95CI%: 54.30 - 92.54%), false-negative rate was 21.7%.
Conclusions:
The sensitivity of chest CT was found to be low and any significant correlations could have not been depicted, between the radiological parameters and the presence of lymphopenia. Clinical follow-up combined with corresponding pathogen detection, and chest CT of the symptomatic COVID-19 patients might be a feasible/prompt protocol in children.
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