TY - JOUR
T1 - Thoracic imaging of coronavirus disease 2019 (COVID-19) in children
T2 - a series of 91 cases
AU - Collaborators of the European Society of Paediatric Radiology Cardiothoracic Task Force
AU - Caro-Dominguez, Pablo
AU - Shelmerdine, Susan Cheng
AU - Toso, Seema
AU - Secinaro, Aurelio
AU - Toma, Paolo
AU - Damasio, Maria Beatrice
AU - Navallas, María
AU - Riaza-Martin, Lucia
AU - Gomez-Pastrana, David
AU - Ghadimi Mahani, Maryam
AU - Desoky, Sarah M
AU - Ugas Charcape, Carlos F
AU - Almanza-Aranda, Judith
AU - Ucar, Maria Elena
AU - Lovrenski, Jovan
AU - Gorkem, Sureyya Burcu
AU - Alexopoulou, Efthymia
AU - Ciet, Pierluigi
AU - van Schuppen, Joost
AU - Ducou le Pointe, Hubert
AU - Goo, Hyun Woo
AU - Kellenberger, Christian J
AU - Raissaki, Maria
AU - Owens, Catherine M
AU - Hirsch, Franz Wolfgang
AU - van Rijn, Rick R
PY - 2020/9
Y1 - 2020/9
N2 - 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.
AB - 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.
KW - Adolescent
KW - Betacoronavirus
KW - COVID-19
KW - Child
KW - Child, Preschool
KW - Coronavirus Infections/diagnostic imaging
KW - Female
KW - Humans
KW - Infant
KW - Infant, Newborn
KW - Lung/diagnostic imaging
KW - Male
KW - Pandemics
KW - Pneumonia, Viral/diagnostic imaging
KW - Radiography, Thoracic/methods
KW - Reproducibility of Results
KW - Retrospective Studies
KW - SARS-CoV-2
KW - Tomography, X-Ray Computed/methods
U2 - 10.1007/s00247-020-04747-5
DO - 10.1007/s00247-020-04747-5
M3 - Article
C2 - 32749530
VL - 50
SP - 1354
EP - 1368
JO - Pediatric Radiology
JF - Pediatric Radiology
SN - 0301-0449
IS - 10
ER -