Imaging Findings of SARS-CoV-2 Infection in Pediatrics: A Systematic Review of Coronavirus Disease 2019 (COVID-19) in 850 Patients

Abstract

Rationale and objectives Children with COVID-19 seem to have a relatively milder disease and better prognosis; however, severe disease or death could still occur in this age group. Although the knowledge on the clinical and epidemiology of COVID‐19 in pediatric patients is being accumulated rapidly, relevant comprehensive review on its radiological manifestations is still lacking. The present article reviews the radiological characteristics of COVID‐19 in pediatrics, based on the previous studies. Materials and methods We conducted a systematic literature search for published articles by using Medline, Scopus, Google Scholar and Embase online databases. All studies describing CT findings of COVID-19 in pediatrics (<18years) were included. Results A total of 39 studies with 850 pediatric patients were reviewed. 225 (26.5%) of patients had normal CT findings. Ground-glass opacities and consolidations were the most common CT abnormalities (384/625, 61.5%). Other findings were halo sign, interstitial opacities, bronchial wall thickening, and crazy-paving sign. Approximately 55% of patients had unilateral pulmonary findings. Most studies found peripheral and lower-lobe distribution to be a prominent imaging finding. Conclusion Our study showed that imaging findings in children were often milder and more focal than adults, typically as ground-glass opacities and consolidations with unilateral lower-lobe predominance, which have been regressed during the recovery time. A balance must be struck between the risk of radiation and the need for chest CT. If still necessary, low-dose CT is more appropriate in this age group. Albeit, due to the limited number of reported pediatrics with COVID-19, and the lack of consistency in CT descriptors, further work is still needed in this regard.

Low impact of SARS-CoV-2 infection among paediatric acute respiratory disease hospitalizations

“…Pneumonia was the main clinical diagnosis among SARS-CoV-2( + ) children, and they showed indistinguishable clinical and radiological characteristics at hospital admission from those SARS-CoV-2(-), as observed by others. 4 Nonetheless, the two groups showed different analytical features and SARS-CoV-2( + ) patients were significantly older.…”

“…Lower respiratory tract infections are one of the leading causes of paediatric mortality and morbidity worldwide, and they also cause a high number of hospitalizations in well-developed countries. 2 Several reports have described that SARS-CoV-2 infection causes a much milder respiratory disease in children in comparison to adults, 3 , 4 , 5 , 6 but the real burden of SARS-CoV-2 infection in children requiring for hospital admission due to ALRD during the pandemics has not been addressed specifically. This study describes the clinical, epidemiological, and microbiological characteristics of children requiring admission with an ALRD during the first pandemic wave.…”

Imaging Features of Pediatric COVID-19 on Chest Radiography and Chest CT: A Retrospective, Single-Center Study

“…Radiological manifestations of COVID-19 vary between age groups (8). A recent study (9) reviewed the studies investigating imaging characteristics of COVID-19 in children with a small sample size (10À14). In this article, we aimed to document the chest radiography and chest CT imaging findings of children with COVID-19 from a single academic center and to compare our results with the existing literature.…”

COVID-19 in pregnancy: a systematic review of chest CT findings and associated clinical features in 427 patients

“… 27 Compared with our results, these findings suggest that pregnant patients may have a slightly lower prevalence of bilateral involvement of COVID-19 disease than the general population (69.4% vs. 79–87.5%), which is consistent with data suggesting lower rates of bilateral disease in younger populations. 28 Additionally, our results suggest that pregnant patients may have lower rates of GGOs (77.2% vs. 88.0%) and higher rates of consolidation compared to the general population (40.9% vs. 21.0–31.8%). These comparisons are further detailed in Table 5 .…”