CT features of novel coronavirus pneumonia (COVID-19) in children

Abstract

A serious epidemic of COVID-19 broke out in Wuhan, Hubei Province, China, and spread to other Chinese cities and several countries now. As the majority of patients infected with COVID-19 had chest CT abnormality, chest CT has become an important tool for early diagnosis of COVID-19 and monitoring disease progression. There is growing evidence that children are also susceptible to COVID-19 and have atypical presentations compared with adults. This review is mainly about the differences in clinical symptom spectrum, diagnosis of COVID-19, and CT imaging findings between adults and children, while highlighting the value of radiology in prevention and control of COVID-19 in pediatric patients. Key points • Compared with adults, pediatric patients with COVID-19 have the characteristics of lower incidence, slighter clinical symptoms, shorter course of disease, and fewer severe cases. • The chest CT characteristics of COVID-19 in pediatric patients were atypical, with more localized GGO extent, lower GGO attenuation, and relatively rare interlobular septal thickening. • Chest CT should be used with more caution in pediatric patients with COVID-19 to protect this vulnerable population from risking radiation.

Coronavirus Disease 2019 Infection among Children: Pathogenesis, Treatment, and Outcome

“…57 Normal findings on chest CT were observed in pediatric patients with mild COVID-19 illness; however, few of them had disease progression on CT scan showing more localized GGO extent, lower GGO attenuation, and relatively rare interlobular septal thickening. 5 Feng et al reported smaller nodular GGO in COVID-19 pediatric patients. However, other features such as interlobular septa thickening, consolidation, GGO with consolidation have also been observed.…”

“…Low risk consists of people in endemic areas outside the source of epidemic. 5 COVID-19 clinical manifestations in children may be less severe compared with adults. This may be related to both host factors and exposure.…”

小児におけるCOVID–19の特徴と救急診療上の注意点(Characteristics and considerations in the medical treatment for COVID–19 in children)

“…成人のCOVID–19確定患者について，初診時のPCR検査とCT検査による感度はそれぞれ84.6%，97.2%であったとの報告がある 。CT検査所見では肺野背側および末梢側に出現するground–glass opacification（GGO）とよばれる間質陰影が特徴といわれるが , ，さらに小児の特徴的所見として，肺葉をまたがず，より限局した範囲に淡い陰影として出現するGGO や，haloを伴う浸潤影 が報告されている。15歳未満のCOVID–19確定患者15人において，無症状であった8人のうち7人（初診時4人，経過中3人）にGGOを認めたという報告もあり ，小児においてもPCR検査とCT検査を合わせて用いることでより感度の高い診断ができる可能性がある。…”

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

“…16 Chest CT abnormalities can be found in patients with negative RT-PCR. 26 On the contrary, a variable proportion of symptomatic children with COVID-19 may have a negative chest CT. 20 Besides, in the early studies published in Chinese and assessed in a systematic review by Duan et al, 20 Chinese children with COVID-19 exhibited specific imaging features on chest CT, different from those described in adults. 19,24 The scope of the present systematic review is to analyse the recent studies that appeared in the English literature focusing on the chest CT features at diagnosis in children with RT-PCR-confirmed COVID-19.…”

“…15 Although CT studies on patients with COVID-19 included a variable number of children and adolescents, studies focusing on COVID-19 infection in children are limited and performed in small populations. [19][20][21][22][23][24] In adults with COVID-19, chest CT abnormalities might appear before clinical symptoms, 25 and be disproportionately severe. 16 Chest CT abnormalities can be found in patients with negative RT-PCR.…”