Thoracic imaging of coronavirus disease 2019 (COVID-19) in children: a series of 91 cases.
Adolescent
Betacoronavirus
COVID-19
Child
Child, Preschool
Coronavirus Infections
/ diagnostic imaging
Female
Humans
Infant
Infant, Newborn
Lung
/ diagnostic imaging
Male
Pandemics
Pneumonia, Viral
/ diagnostic imaging
Radiography, Thoracic
/ methods
Reproducibility of Results
Retrospective Studies
SARS-CoV-2
Tomography, X-Ray Computed
/ methods
COVID-19
Children
Computed tomography
Coronavirus
Imaging
Lower respiratory tract infection
Pneumonitis
Radiography
Journal
Pediatric radiology
ISSN: 1432-1998
Titre abrégé: Pediatr Radiol
Pays: Germany
ID NLM: 0365332
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
received:
13
04
2020
accepted:
25
05
2020
revised:
14
05
2020
pubmed:
5
8
2020
medline:
17
9
2020
entrez:
5
8
2020
Statut:
ppublish
Résumé
Pulmonary infection with SARS-CoV-2 virus (severe acute respiratory syndrome coronavirus 2; COVID-19) has rapidly spread worldwide to become a global pandemic. To collect paediatric COVID-19 cases worldwide and to summarize both clinical and imaging findings in children who tested positive on polymerase chain reaction testing for SARS-CoV-2. Data were collected by completion of a standardised case report form submitted to the office of the European Society of Paediatric Radiology from March 12 to April 8, 2020. Chest imaging findings in children younger than 18 years old who tested positive on polymerase chain reaction testing for SARS-CoV-2 were included. Representative imaging studies were evaluated by multiple senior paediatric radiologists from this group with expertise in paediatric chest imaging. Ninety-one children were included (49 males; median age: 6.1 years, interquartile range: 1.0 to 13.0 years, range: 9 days-17 years). Most had mild symptoms, mostly fever and cough, and one-third had coexisting medical conditions. Eleven percent of children presented with severe symptoms and required intensive unit care. Chest radiographs were available in 89% of patients and 10% of them were normal. Abnormal chest radiographs showed mainly perihilar bronchial wall thickening (58%) and/or airspace consolidation (35%). Computed tomography (CT) scans were available in 26% of cases, with the most common abnormality being ground glass opacities (88%) and/or airspace consolidation (58%). Tree in bud opacities were seen in 6 of 24 CTs (25%). Lung ultrasound and chest magnetic resonance imaging were rarely utilized. It seems unnecessary to perform chest imaging in children to diagnose COVID-19. Chest radiography can be used in symptomatic children to assess airway infection or pneumonia. CT should be reserved for when there is clinical concern to assess for possible complications, especially in children with coexisting medical conditions.
Sections du résumé
BACKGROUND
Pulmonary infection with SARS-CoV-2 virus (severe acute respiratory syndrome coronavirus 2; COVID-19) has rapidly spread worldwide to become a global pandemic.
OBJECTIVE
To collect paediatric COVID-19 cases worldwide and to summarize both clinical and imaging findings in children who tested positive on polymerase chain reaction testing for SARS-CoV-2.
MATERIALS AND METHODS
Data were collected by completion of a standardised case report form submitted to the office of the European Society of Paediatric Radiology from March 12 to April 8, 2020. Chest imaging findings in children younger than 18 years old who tested positive on polymerase chain reaction testing for SARS-CoV-2 were included. Representative imaging studies were evaluated by multiple senior paediatric radiologists from this group with expertise in paediatric chest imaging.
RESULTS
Ninety-one children were included (49 males; median age: 6.1 years, interquartile range: 1.0 to 13.0 years, range: 9 days-17 years). Most had mild symptoms, mostly fever and cough, and one-third had coexisting medical conditions. Eleven percent of children presented with severe symptoms and required intensive unit care. Chest radiographs were available in 89% of patients and 10% of them were normal. Abnormal chest radiographs showed mainly perihilar bronchial wall thickening (58%) and/or airspace consolidation (35%). Computed tomography (CT) scans were available in 26% of cases, with the most common abnormality being ground glass opacities (88%) and/or airspace consolidation (58%). Tree in bud opacities were seen in 6 of 24 CTs (25%). Lung ultrasound and chest magnetic resonance imaging were rarely utilized.
CONCLUSION
It seems unnecessary to perform chest imaging in children to diagnose COVID-19. Chest radiography can be used in symptomatic children to assess airway infection or pneumonia. CT should be reserved for when there is clinical concern to assess for possible complications, especially in children with coexisting medical conditions.
Identifiants
pubmed: 32749530
doi: 10.1007/s00247-020-04747-5
pii: 10.1007/s00247-020-04747-5
pmc: PMC7399600
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1354-1368Subventions
Organisme : Department of Health
ID : CDF-2017-10-037
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/R002118/1
Pays : United Kingdom
Investigateurs
Owen Arthurs
(O)
Michiel Bannier
(M)
Francesco Bianco
(F)
Roham Borazjani
(R)
Mark Born
(M)
Jasmin Buschl
(J)
Marirosa Cristallo Lacalamita
(MC)
Francesca De Luca
(F)
Marco Di Maurizio
(M)
Francesca Finazzo
(F)
Karsten Jablonka
(K)
Mark Jenkins
(M)
Karmella Kamali
(K)
Letizia Macconi
(L)
Carlos Marín
(C)
María Martínez León
(MM)
Baptiste Morel
(B)
Inmaculada Mota Goitia
(IM)
Marcello Napolitano
(M)
Nin-Yuan Pan
(NY)
Elham Pourbkhtyaran
(E)
Friederike Prüfer
(F)
Enrica Rossi
(E)
Carrie Ruzal-Shapiro
(C)
Anahita Sanaei Dashti
(AS)
Ana Gabriela Sangri Pinto
(AG)
Charlotte Seiler
(C)
Maria Sole Prevedoni Gorone
(MSP)
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