Chest CT features of coronavirus disease 2019 (COVID-19) in pediatric patients and its correlation with the clinical condition

Abstract Background All pediatric health organizations are concerned about the impact of coronavirus disease on children, especially on those with other comorbidities; fortunately, pediatric cases appear to be less severe than in adults (De Luca et al. in Pediatr Respir Rev 5:9–14, 2020). The purpos...

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Main Authors: Abeer El-Sayed Gabr, Abeer Maghawry Abdelhameed, Shaimaa Abdelsattar Mohammad, Eman Mahmoud Fouda, Shimaa Ahmed Maher, Samah Khalaf Fathallah, Mona Gamalludin Alsayed Muhammed Alkaphoury
Format: Article
Language:English
Published: SpringerOpen 2023-01-01
Series:The Egyptian Journal of Radiology and Nuclear Medicine
Subjects:
Online Access:https://doi.org/10.1186/s43055-022-00948-0
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author Abeer El-Sayed Gabr
Abeer Maghawry Abdelhameed
Shaimaa Abdelsattar Mohammad
Eman Mahmoud Fouda
Shimaa Ahmed Maher
Samah Khalaf Fathallah
Mona Gamalludin Alsayed Muhammed Alkaphoury
author_facet Abeer El-Sayed Gabr
Abeer Maghawry Abdelhameed
Shaimaa Abdelsattar Mohammad
Eman Mahmoud Fouda
Shimaa Ahmed Maher
Samah Khalaf Fathallah
Mona Gamalludin Alsayed Muhammed Alkaphoury
author_sort Abeer El-Sayed Gabr
collection DOAJ
description Abstract Background All pediatric health organizations are concerned about the impact of coronavirus disease on children, especially on those with other comorbidities; fortunately, pediatric cases appear to be less severe than in adults (De Luca et al. in Pediatr Respir Rev 5:9–14, 2020). The purpose of this study is to characterize chest CT findings of children with and without comorbidities who had confirmed coronavirus disease (COVID-19) and to investigate the relation between chest CT findings and the clinical severity of COVID-19 pneumonia and their laboratory findings. Results The study was conducted on 36 patients, 72.2% of whom had associated comorbidities. Twenty-three patients (63.88%) had abnormal CT findings. Consolidative patches were the most common radiological sign (55.6%) followed by ground glass opacities (50%). The lesions were bilateral (58.3%), having predominantly peripheral distribution (38.9%) with predominant left lower lobe affection (25%). Cases with clinically severe chest conditions had significantly more prevalent consolidative patches (p = 0.026) which show a higher CT density (p = 0.01) and a significantly higher CT severity score (SS) compared to other groups (p = 0.029). The cutoff of severity score 4/20 had 100% sensitivity and 78.12% specificity in the diagnosis of severe cases. There were no statistically significant differences between patients with or without comorbidities regarding CT-SS or any radiological signs. Conclusions Consolidation was the most common radiological finding in children with COVID-19 and was more prevalent and denser in severe cases. The CT-SS may be used as a complementary tool for the evaluation of the severity of the chest condition. Chest CT-SS more than 4 can be used as an indicator of severe cases, yet no significant difference in CT-SS between patients with associated comorbidities or not.
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spelling doaj.art-0472952747064a11b6f6c54245493ced2023-01-08T12:07:44ZengSpringerOpenThe Egyptian Journal of Radiology and Nuclear Medicine2090-47622023-01-0154111010.1186/s43055-022-00948-0Chest CT features of coronavirus disease 2019 (COVID-19) in pediatric patients and its correlation with the clinical conditionAbeer El-Sayed Gabr0Abeer Maghawry Abdelhameed1Shaimaa Abdelsattar Mohammad2Eman Mahmoud Fouda3Shimaa Ahmed Maher4Samah Khalaf Fathallah5Mona Gamalludin Alsayed Muhammed Alkaphoury6Department of Diagnostic and Interventional Radiology and Molecular Imaging, Faculty of Medicine, Ain Shams UniversityDepartment of Diagnostic and Interventional Radiology and Molecular Imaging, Faculty of Medicine, Ain Shams UniversityDepartment of Diagnostic and Interventional Radiology and Molecular Imaging, Faculty of Medicine, Ain Shams UniversityPediatric Department Faculty of Medicine, Ain Shams UniversityPediatric Department Faculty of Medicine, Ain Shams UniversityPediatric Department Faculty of Medicine, Ain Shams UniversityDepartment of Diagnostic and Interventional Radiology and Molecular Imaging, Faculty of Medicine, Ain Shams UniversityAbstract Background All pediatric health organizations are concerned about the impact of coronavirus disease on children, especially on those with other comorbidities; fortunately, pediatric cases appear to be less severe than in adults (De Luca et al. in Pediatr Respir Rev 5:9–14, 2020). The purpose of this study is to characterize chest CT findings of children with and without comorbidities who had confirmed coronavirus disease (COVID-19) and to investigate the relation between chest CT findings and the clinical severity of COVID-19 pneumonia and their laboratory findings. Results The study was conducted on 36 patients, 72.2% of whom had associated comorbidities. Twenty-three patients (63.88%) had abnormal CT findings. Consolidative patches were the most common radiological sign (55.6%) followed by ground glass opacities (50%). The lesions were bilateral (58.3%), having predominantly peripheral distribution (38.9%) with predominant left lower lobe affection (25%). Cases with clinically severe chest conditions had significantly more prevalent consolidative patches (p = 0.026) which show a higher CT density (p = 0.01) and a significantly higher CT severity score (SS) compared to other groups (p = 0.029). The cutoff of severity score 4/20 had 100% sensitivity and 78.12% specificity in the diagnosis of severe cases. There were no statistically significant differences between patients with or without comorbidities regarding CT-SS or any radiological signs. Conclusions Consolidation was the most common radiological finding in children with COVID-19 and was more prevalent and denser in severe cases. The CT-SS may be used as a complementary tool for the evaluation of the severity of the chest condition. Chest CT-SS more than 4 can be used as an indicator of severe cases, yet no significant difference in CT-SS between patients with associated comorbidities or not.https://doi.org/10.1186/s43055-022-00948-0COVID-19CT severity scoreROC = receiver operating characteristicLLL = left lower lobeDCL = disturbed conscious levelDKA = diabetic ketoacidosis
spellingShingle Abeer El-Sayed Gabr
Abeer Maghawry Abdelhameed
Shaimaa Abdelsattar Mohammad
Eman Mahmoud Fouda
Shimaa Ahmed Maher
Samah Khalaf Fathallah
Mona Gamalludin Alsayed Muhammed Alkaphoury
Chest CT features of coronavirus disease 2019 (COVID-19) in pediatric patients and its correlation with the clinical condition
The Egyptian Journal of Radiology and Nuclear Medicine
COVID-19
CT severity score
ROC = receiver operating characteristic
LLL = left lower lobe
DCL = disturbed conscious level
DKA = diabetic ketoacidosis
title Chest CT features of coronavirus disease 2019 (COVID-19) in pediatric patients and its correlation with the clinical condition
title_full Chest CT features of coronavirus disease 2019 (COVID-19) in pediatric patients and its correlation with the clinical condition
title_fullStr Chest CT features of coronavirus disease 2019 (COVID-19) in pediatric patients and its correlation with the clinical condition
title_full_unstemmed Chest CT features of coronavirus disease 2019 (COVID-19) in pediatric patients and its correlation with the clinical condition
title_short Chest CT features of coronavirus disease 2019 (COVID-19) in pediatric patients and its correlation with the clinical condition
title_sort chest ct features of coronavirus disease 2019 covid 19 in pediatric patients and its correlation with the clinical condition
topic COVID-19
CT severity score
ROC = receiver operating characteristic
LLL = left lower lobe
DCL = disturbed conscious level
DKA = diabetic ketoacidosis
url https://doi.org/10.1186/s43055-022-00948-0
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