CT Features of Coronavirus Disease (COVID-19) in 30 Pediatric Patients

Steinberger, Sharon; Lin, Bin; Bernheim, Adam; Chung, Michael; Gao, Yuantong; Xie, Zongyu; Zhao, Tongtong; Xia, Junli; Mei, Xueyan; Little, Brent P.

doi:10.2214/ajr.20.23145

Cited by 68 publications

(110 citation statements)

References 10 publications

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“…The areas of GGO were seen to be mainly isolated (not associated with consolidation) in eight out of the nine studies 13,19,21,22,24,31,33,34 ranging from 12.5% to 100% of the cases. GGOs with areas of consolidation were also frequently reported in five series 13,19,23,31,34 ranging from 14% in the series by Steinberger et al 34 to up to 87% in the series by Sun et al 13 Ma et al 31 reported local (37%) and bilateral (21%) 'patchy shadowing' (i.e. consolidation) in the group of children with positive CT findings in their series, with no specification of whether this was found in combination with GGO, which they described in 67% of the patients in the same group.…”

Section: Discussionmentioning

confidence: 93%

“…In case of the presence of abnormalities on chest CT, the alterations seemed more frequently bilateral. Bilateral versus unilateral involvement was reported in six 13,19,21,23,24,34 of the nine selected articles. Bilateral involvement ranged from 57.1% to 75%, and unilateral involvement ranged from 25% to 42.9%.…”

Section: Discussionmentioning

confidence: 99%

“…Eleven articles 13,19,[21][22][23][24][30][31][32][33][34] matched the selection criteria and were selected for the full-text assessment. One of the articles 30 was excluded after reading the full text (high-resolution CT study, including both adults and children, with lack of specific information for the comparative assessment).…”

Section: Selected Articlesmentioning

confidence: 99%

“…Eight articles 19,[21][22][23][24]31,33,34 were included for the final analysis. A ninth article 13 was hand-selected from the references section of the review article by Duan et al 20 This article was attentively read, and references compared, with the aim to minimize overlapping.…”

Section: Selected Articlesmentioning

confidence: 99%

“…The National Institutes of Health (NIH) Quality Assessment Tool was applied to assess the quality of the selected articles ( Table 2). The PRISMA assessment of 23 Xia et al 24 Chen et al 19 Li et al 21 Lu et al 33 Li et al 22 Sun et al 13 Ma et al 31 Steinberger et al 34 Patient enrolment the quality of the present systematic review is presented in Figure 1.…”

Section: Selected Articlesmentioning

confidence: 99%

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Chest computed tomography (CT) features in children with reverse transcription‐polymerase chain reaction (RT‐PCR)‐confirmed COVID‐19: A systematic review

et al. 2020

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To describe the chest CT features reported in children with confirmed COVID-19 infection, published in English literature. A systematic review was completed on PubMed, Embase and Scopus databases on the 1st of June 2020 using the PICO strategy. The NIH Quality Assessment Tool was used to assess the quality of the selected articles. The systematic review was evaluated by Case Series Studies and the Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies (PRISMA). The extracted data were assessed and compared with those reported in the adult population. Seventy-two articles were retrieved from the database search and screened by the title, abstract and keywords. Eleven articles were deemed eligible for full-text assessment. Nine articles were included for the data extraction and in the final analysis. Chest CT features in children with COVID-19 differ from those in adults. 'Groundgrass opacities' (GGOs) are the most commonly described abnormalities, but closely followed by a combination of GGO and consolidation, not usual in adults. Children tend to have a more variable involvement than the subpleural and posterior and basal topography described in adults. Interlobular thickening and air bronchogram found in adults with COVID-19 are not frequent in children. Pulmonary embolism reported in up to 30% of adults has not been yet reported in children. Original articles describing chest CT features in children with COVID-19 in the English literature are limited to small populations of Chinese children. Chest CT imaging features are very diverse across the selected studies and globally different from those reported in adults. Data from children of different countries would provide a more comprehensive description of chest CT features in children with COVID-19.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Selected Articlesmentioning

confidence: 99%

Section: Selected Articlesmentioning

confidence: 99%

Section: Selected Articlesmentioning

confidence: 99%

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Chest computed tomography (CT) features in children with reverse transcription‐polymerase chain reaction (RT‐PCR)‐confirmed COVID‐19: A systematic review

et al. 2020

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Lung ultrasound for evaluation of pediatric COVID‐19 infection: What we already know, what we need to investigate now, and what we can expect in the future

Lee

Winant

2021

Pediatric Pulmonology

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| 1295with MIS-C who often present with heart failure (left ventricular systolic dysfunction), coronary artery dilatation, pulmonary edema, and pleural effusion. [8][9][10] Stepping outside the box of conventional approach to imaging, diagnosis, and management brings both challenges and opportunities. Despite some challenges and limitations in their study, the authors have provided us with an important stepping stone of information that may yield new opportunities to improve our understanding, diagnosis, and management of COVID-19 infection in pediatric patients in the future. AUTHOR CONTRIBUTIONSEdward Y. Lee: Conceptualization (equal); project administration (equal); writing original draft (equal); writing review and editing (equal). Abbey J. Winant: Conceptualization (equal); project administration (equal); writing original draft (equal); writing review and editing (equal).

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Comparison of chest radiography and chest CT for evaluation of pediatric COVID‐19 pneumonia: Does CT add diagnostic value?

Das

Alkoteesh

Kaabi

et al. 2021

Pediatric Pulmonology

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Purpose First, to investigate the added diagnostic value of chest computed tomography (CT) for evaluating COVID‐19 in symptomatic children by comparing chest CT findings with chest radiographic findings, and second, to identify the imaging signs and patterns on CT associated with COVID‐19 pneumonia in children. Materials and Methods From March 2020 to December 2020, 56 consecutive children (33 males and 23 girls; mean age ± SD , 14.8 ± 5.0 years; range, 9 months–18 years) with mild to moderate symptom and laboratory confirmed COVID‐19 (based on Centers for Disease Control criteria) underwent both chest radiography and chest CT on the same day within the first 2 days of initial presentation to the hospital. Two experienced radiologists independently evaluated chest radiographs and chest CT studies for thoracic abnormalities. The findings from chest radiography and chest CT were compared to evaluate the added diagnostic value of chest CT for affecting patient management. Interobserver agreement was measured with Cohen's κ statistics. Results Eleven (19.6%) of 56 patients had abnormal chest radiographic findings, including ground‐glass opacity (GGO) in 5/11 (45.4%) and combined GGO and consolidation in 6/11 (54.5%). On chest CT, 26 (46.4%) of 56 patients had abnormal CT findings, including combined GGO and consolidation in 19/26 (73.1%), GGO in 6/26 (23.1%), and consolidation in 1/26 (3.8%). Chest CT detected all thoracic abnormalities seen on chest radiography in 11/26 (42.3%) cases. In 15/26 (57.7%), chest CT detected lung abnormalities that were not observed on chest radiography, which included GGO and consolidation in 9/15 (60%), GGO in 5/15 (33.3%), and consolidation in 1/15 (6.6%) cases. These additional CT findings did not affect patient management. In addition, chest CT detected radiological signs and patterns, including the halo sign, reversed halo sign, crazy paving pattern, and tree‐in‐bud pattern. There was almost perfect interobserver agreement between the two reviewers for detecting findings on both chest radiographs ( κ , 0.89, p = .001) and chest CT ( κ , 0.96, p = .001) studies. Conclusion Chest CT detected lung abnormalities, including GGO and/or consolidation, that were not observed on chest radiography in more than half of symptomatic pediatric patients with COVID‐19 pneumonia. However, these additional CT findings did not affect patient management. Therefore, CT is not clinically indicated for the initial evaluation of mild to moderately symptomatic pediatric patients with COVID‐19 pneumonia.

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CT Features of Coronavirus Disease (COVID-19) in 30 Pediatric Patients

Cited by 68 publications

References 10 publications

Chest computed tomography (CT) features in children with reverse transcription‐polymerase chain reaction (RT‐PCR)‐confirmed COVID‐19: A systematic review

Chest computed tomography (CT) features in children with reverse transcription‐polymerase chain reaction (RT‐PCR)‐confirmed COVID‐19: A systematic review

Lung ultrasound for evaluation of pediatric COVID‐19 infection: What we already know, what we need to investigate now, and what we can expect in the future

Comparison of chest radiography and chest CT for evaluation of pediatric COVID‐19 pneumonia: Does CT add diagnostic value?

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