Clinical and CT features in pediatric patients with COVID‐19 infection: Different points from adults

Abstract

Purpose To discuss the different characteristics of clinical, laboratory, and chest computed tomography (CT) in pediatric patients from adults with 2019 novel coronavirus (COVID‐19) infection. Methods The clinical, laboratory, and chest CT features of 20 pediatric inpatients with COVID‐19 infection confirmed by pharyngeal swab COVID‐19 nucleic acid test were retrospectively analyzed during 23 January and 8 February 2020. The clinical and laboratory information was obtained from inpatient records. All the patients were undergone chest CT in our hospital. Results Thirteen pediatric patients (13/20, 65%) had an identified history of close contact with COVID‐19 diagnosed family members. Fever (12/20, 60%) and cough (13/20, 65%) were the most common symptoms. For laboratory findings, procalcitonin elevation (16/20, 80%) should be pay attention to, which is not common in adults. Coinfection (8/20, 40%) is common in pediatric patients. A total of 6 patients presented with unilateral pulmonary lesions (6/20, 30%), 10 with bilateral pulmonary lesions (10/20, 50%), and 4 cases showed no abnormality on chest CT (4/20, 20%). Consolidation with surrounding halo sign was observed in 10 patients (10/20, 50%), ground‐glass opacities were observed in 12 patients (12/20, 60%), fine mesh shadow was observed in 4 patients (4/20, 20%), and tiny nodules were observed in 3 patients (3/20, 15%). Conclusion Procalcitonin elevation and consolidation with surrounding halo signs were common in pediatric patients which were different from adults. It is suggested that underlying coinfection may be more common in pediatrics, and the consolidation with surrounding halo sign which is considered as a typical sign in pediatric patients.

COVID-19 Infection in Iranian Children: A Case Series of 9 Patients

“…All cases had household contact with COVID-19 cases. Although diarrhea and runny nose have been reported in Chinese cases, none of our patients experienced these symptoms, suggesting that the signs and symptoms in children may be different from adults (1,5,9).…”

“…Abnormal laboratory results include leukopenia, lymphopenia, and thrombocytopenia, elevated LDH, CPK, procalcitonin, ESR, and CRP (1,9). In our cases, leukopenia and lymphopenia were observed in only 3 cases despite their poor condition.…”

“…Elevated ESR and CRP were detected in all cases. We did not measure procalcitonin in our patients, but in the study of Wei et al 2020, elevated procalcitonin was shown (80%) in pediatrics with COVID-19 infection, a condition not common in adults (9). RT-PCR test result of 3 patients was positive.…”

“…According to the national guidelines, the diagnosis of COVID-19 is confirmed by reverse-transcription polymerase chain reaction (RT-PCR) test from pharyngeal swab samples and detection of lesions by chest CT-scan (5)(6)(7)(8)(9). However, according to the experience of fellow Chinese physicians, chest CT-scan had a sensitivity of 97% for diagnosing COVID-19-even superior to RT-PCR (10).…”

Clinical characteristics and diagnostic challenges of pediatric COVID-19: A systematic review and meta-analysis

“…In addition, all neonates tested negative for SARS-CoV-2. Liu et al 11 Feng et al 12 Cai et al 13 Xia et al 14 Wang et al 15 Jiang et al 16…”