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Published on: December 19, 2020
Radiographic patterns and severity scoring of COVID-19 pneumonia in children: a retrospective study
Jumlong Saelim1,2, Supika Kritsaneepaiboon3, Vorawan Charoonratana1
1Department of Radiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, 90110, Thailand.
Insights
This study analyzed chest radiography (CXR) in pediatric COVID-19 pneumonia, finding peribronchial thickening common in younger children and ground-glass opacity in older children. Most cases showed mild lung abnormalities on CXR.
Area of Science:
- Pediatric Radiology
- Infectious Disease Imaging
- COVID-19 Research
Background:
- Chest radiography (CXR) is crucial for managing COVID-19 pneumonia in children.
- Understanding radiographic patterns aids in treatment planning and monitoring disease progression.
Purpose of the Study:
- To detail the radiographic patterns and severity scores of abnormal CXR findings in pediatric COVID-19 pneumonia.
- To correlate CXR findings with age and disease severity in children.
Main Methods:
- Retrospective analysis of chest radiographs from children with confirmed COVID-19.
- Review of CXR findings and assessment using a modified radiographic scoring system.
Main Results:
- 10.9% of pediatric COVID-19 cases showed abnormal CXR findings.
- Peribronchial thickening was most common overall (51%), prevalent in children <5 years.
- Ground-glass opacity (GGO) was more frequent in children >9 years (73.1%).
- Lower lung zones were most affected (52.8%); most abnormalities were mild (76.4%).
Conclusions:
- Radiographic features of COVID-19 pneumonia in children vary by age.
- Peribronchial thickening and GGO show distinct age distributions.
- Higher CXR severity scores correlate with increased need for medical treatment and oxygen support.
Background:
Chest radiography (CXR) is an adjunct tool in treatment planning and monitoring of the disease course of COVID-19 pneumonia. The purpose of the study was to describe the radiographic patterns and severity scores of abnormal CXR findings in children diagnosed with COVID-19 pneumonia.
Methods:
This retrospective study included children with confirmed COVID-19 by reverse transcriptase-polymerase chain reaction test who underwent CXR at the arrival. The CXR findings were reviewed, and modified radiographic scoring was assessed.
Results:
The number of abnormal CXR findings was 106 of 976 (10.9%). Ground-glass opacity (GGO) was commonly found in children aged > 9 years (19/26, 73.1%), whereas peribronchial thickening was predominantly found in children aged < 5 years (25/54, 46.3%). Overall, the most common radiographic finding was peribronchial thickening (54/106, 51%). The lower lung zone (56/106, 52.8%) was the most common affected area, and there was neither peripheral nor perihilar predominance (84/106, 79.2%). Regarding the severity of COVID-19 pneumonia based on abnormal CXR findings, 81 of 106 cases (76.4%) had mild lung abnormalities. Moderate and severe lung abnormalities were found in 21 (19.8%) and 4 (3.8%) cases, respectively. While there were no significant differences in the radiographic severity scores among the various pediatric age groups, there were significant disparities in severity scores in the initial CXR and medical treatments.
Conclusions:
This study clarified the age distribution of radiographic features across the pediatric population. GGO was commonly found in children aged > 9 years, whereas peribronchial thickening was predominant in children aged < 5 years. The lower lung zone was the most common affected area, and the high severity lung scores required more medical treatments and oxygen support.
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