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Covid-19’lu Pediatrik Vakalardaki Toraks Tomografisi Bulgularının Yaşlara Göre Dağılımı , Thoracic computed tomography findings of pediatric COVID-19 cases according to age groups

Yıl 2023, , 48 - 55, 31.08.2023
https://doi.org/10.33713/egetbd.1289607

Öz

Objective: In this study, we aimed to evaluate thoracic computed tomography (CT) findings of pediatric patients with novel coronavirus disease 2019 (COVID-19) pneumonia according to age groups.
Methods: A total of 105 patients aged between 0 and 18 years who were admitted to our clinic between April 2020 and September 2020 were retrospectively analyzed. The definitive diagnosis was established by reverse transcriptase-polymerase chain reaction (RT-PCR) testing of the combined nasopharyngeal/oropharyngeal swabs. The patients were divided into three groups according to age: 0-6, 6-12, and 12-18 years. Thoracic CT findings at the time of initial admission were evaluated.
Results: Of the patients, 51 had RT-PCR positivity for COVID-19, while 54 had RT-PCR negativity. Of the RT-PCR-positive patients, 30 (58.8%) had normal CT, while lung involvement was observed in 21 patients (41.2%). The most common thoracic CT findings were bilateral lung involvement (27.5%), lower lobe involvement (31.4%), nodular involvement (31.4%), and ground-glass opacity (37.3%). In the 6-12 age group, middle lobe involvement was significantly more frequent (p=0.041). The rate of consolidation significantly decreased with the increasing age (p=0.045).
Conclusion: The most common CT findings were bilateral, peripheral lower lobe involvement in pediatric COVID-19 cases. Consolidation was the most frequent lesion in the 0-6 age group, which can be attributed to the high incidence of bacterial co-infection. In the 12-18 age group, the distribution, morphology, and opacity of the lesions were comparable with those seen in adults. The lesions presented with nodular and ground-glass opacity patterns in the 6-12 and 12-18 age groups.

Kaynakça

  • Ye Z, Zhang Y, Wang Y, Huang Z, Song B. Chest CT manifestations of new coronavirus disease 2019 (COVID-19): a pictorial review. Eur Radiol. 2020;30(8):4381-4389. doi:10.1007/s00330-020-06801-0
  • Wang W, Tang J, Wei F. Updated understanding of the outbreak of 2019 novel coronavirus (2019-nCoV) in Wuhan, China. J Med Virol. 2020;92(4):441-447. doi:10.1002/jmv.25689
  • Lu X, Zhang L, Du H, et al. SARS-CoV-2 Infection in Children. N Engl J Med. 2020;382(17):1663-1665. doi:10.1056/NEJMc2005073
  • Blumfield E, Levin TL. COVID-19 in pediatric patients: a case series from the Bronx, NY. Pediatr Radiol. 2020;50(10):1369-1374. doi:10.1007/s00247-020-04782-2
  • Qiu H, Wu J, Hong L, Luo Y, Song Q, Chen D. Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: an observational cohort study. Lancet Infect Dis. 2020;20(6):689-696. doi:10.1016/S1473-3099(20)30198-5
  • Shi T, McAllister DA, O'Brien KL, et al. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015: a systematic review and modelling study. Lancet. 2017;390(10098):946-958. doi:10.1016/S0140-6736(17)30938-8
  • Meissner HC. Viral Bronchiolitis in Children. N Engl J Med. 2016;374(1):62-72. doi:10.1056/NEJMra1413456
  • Rubin GD, Ryerson CJ, Haramati LB, et al. The Role of Chest Imaging in Patient Management During the COVID-19 Pandemic: A Multinational Consensus Statement From the Fleischner Society. Chest. 2020;158(1):106-116. doi:10.1016/j.chest.2020.04.003
  • Bao C, Liu X, Zhang H, Li Y, Liu J. Coronavirus Disease 2019 (COVID-19) CT Findings: A Systematic Review and Meta-analysis. J Am Coll Radiol. 2020;17(6):701-709. doi:10.1016/j.jacr.2020.03.006
  • Zhu J, Zhong Z, Li H, et al. CT imaging features of 4121 patients with COVID-19: A meta-analysis. J Med Virol. 2020;92(7):891-902. doi:10.1002/jmv.25910
  • Wan S, Li M, Ye Z, et al. CT Manifestations and Clinical Characteristics of 1115 Patients with Coronavirus Disease 2019 (COVID-19): A Systematic Review and Meta-analysis. Acad Radiol. 2020;27(7):910-921. doi:10.1016/j.acra.2020.04.033
  • Cao Y, Liu X, Xiong L, Cai K. Imaging and clinical features of patients with 2019 novel coronavirus SARS-CoV-2: A systematic review and meta-analysis. J Med Virol. 2020;92(9):1449-1459. doi:10.1002/jmv.25822
  • Hansell DM, Bankier AA, MacMahon H, McLoud TC, Müller NL, Remy J. Fleischner Society: glossary of terms for thoracic imaging. Radiology. 2008;246(3):697-722. doi:10.1148/radiol.2462070712
  • Kanne JP. Chest CT Findings in 2019 Novel Coronavirus (2019-nCoV) Infections from Wuhan, China: Key Points for the Radiologist. Radiology. 2020;295(1):16-17. doi:10.1148/radiol.2020200241
  • Shen K, Yang Y, Wang T, et al. Diagnosis, treatment, and prevention of 2019 novel coronavirus infection in children: experts' consensus statement. World J Pediatr. 2020;16(3):223-231. doi:10.1007/s12519-020-00343-7
  • Ludvigsson JF. Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults. Acta Paediatr. 2020;109(6):1088-1095. doi:10.1111/apa.15270
  • Nino G, Zember J, Sanchez-Jacob R, Gutierrez MJ, Sharma K, Linguraru MG. Pediatric lung imaging features of COVID-19: A systematic review and meta-analysis. Pediatr Pulmonol. 2021;56(1):252-263. doi:10.1002/ppul.25070
  • Restrepo-Gualteros SM, Gutierrez MJ, Villamil-Osorio M, Arroyo MA, Nino G. Challenges and Clinical Implications of the Diagnosis of Cytomegalovirus Lung Infection in Children. Curr Infect Dis Rep. 2019;21(7):24. Published 2019 May 30. doi:10.1007/s11908-019-0681-x
  • Mansoor A, Perez G, Nino G, Linguraru MG. Automatic tissue characterization of air trapping in chest radiographs using deep neural networks. Annu Int Conf IEEE Eng Med Biol Soc. 2016;2016:97-100. doi:10.1109/EMBC.2016.7590649
  • Okada K, Golbaz M, Mansoor A, et al. Severity quantification of pediatric viral respiratory illnesses in chest X-ray images. Annu Int Conf IEEE Eng Med Biol Soc. 2015;2015:165-168. doi:10.1109/EMBC.2015.7318326
  • Arroyo M, Salka K, Perez GF, et al. Phenotypical Sub-setting of the First Episode of Severe Viral Respiratory Infection Based on Clinical Assessment and Underlying Airway Disease: A Pilot Study. Front Pediatr. 2020;8:121. Published 2020 Apr 2. doi:10.3389/fped.2020.00121
  • Varga Z, Flammer AJ, Steiger P, et al. Endothelial cell infection and endotheliitis in COVID-19. Lancet. 2020;395(10234):1417-1418. doi:10.1016/S0140-6736(20)30937-5
  • Xia W, Shao J, Guo Y, Peng X, Li Z, Hu D. Clinical and CT features in pediatric patients with COVID-19 infection: Different points from adults. Pediatr Pulmonol. 2020;55(5):1169-1174. doi:10.1002/ppul.24718
  • Foust AM, Phillips GS, Chu WC, et al. International Expert Consensus Statement on Chest Imaging in Pediatric COVID-19 Patient Management: Imaging Findings, Imaging Study Reporting, and Imaging Study Recommendations. Radiol Cardiothorac Imaging. 2020;2(2):e200214. Published 2020 Apr 23. doi:10.1148/ryct.2020200214
  • Bayramoglu Z, Canıpek E, Comert RG, et al. Imaging Features of Pediatric COVID-19 on Chest Radiography and Chest CT: A Retrospective, Single-Center Study. Acad Radiol. 2021;28(1):18-27. doi:10.1016/j.acra.2020.10.002
  • Katal S, Johnston SK, Johnston JH, Gholamrezanezhad A. Imaging Findings of SARS-CoV-2 Infection in Pediatrics: A Systematic Review of Coronavirus Disease 2019 (COVID-19) in 850 Patients. Acad Radiol. 2020;27(11):1608-1621. doi:10.1016/j.acra.2020.07.031
  • Deng Q, Ou C, Chen J, Xiang Y. Particle deposition in tracheobronchial airways of an infant, child and adult. Sci Total Environ. 2018;612:339-346. doi:10.1016/j.scitotenv.2017.08.240
  • Ugas-Charcape CF, Ucar ME, Almanza-Aranda J, et al. Pulmonary imaging in coronavirus disease 2019 (COVID-19): a series of 140 Latin American children. Pediatr Radiol. 2021;51(9):1597-1607. doi:10.1007/s00247-021-05055-2
  • Li K, Wu J, Wu F, et al. The Clinical and Chest CT Features Associated With Severe and Critical COVID-19 Pneumonia. Invest Radiol. 2020;55(6):327-331. doi:10.1097/RLI.0000000000000672

Covid-19’lu Pediatrik Vakalardaki Toraks Tomografisi Bulgularının Yaşlara Göre Dağılımı , Thoracic computed tomography findings of pediatric COVID-19 cases according to age groups

Yıl 2023, , 48 - 55, 31.08.2023
https://doi.org/10.33713/egetbd.1289607

Öz

Objective: In this study, we aimed to evaluate thoracic computed tomography (CT) findings of pediatric patients with novel coronavirus disease 2019 (COVID-19) pneumonia according to age groups.
Methods: A total of 105 patients aged between 0 and 18 years who were admitted to our clinic between April 2020 and September 2020 were retrospectively analyzed. The definitive diagnosis was established by reverse transcriptase-polymerase chain reaction (RT-PCR) testing of the combined nasopharyngeal/oropharyngeal swabs. The patients were divided into three groups according to age: 0-6, 6-12, and 12-18 years. Thoracic CT findings at the time of initial admission were evaluated.
Results: Of the patients, 51 had RT-PCR positivity for COVID-19, while 54 had RT-PCR negativity. Of the RT-PCR-positive patients, 30 (58.8%) had normal CT, while lung involvement was observed in 21 patients (41.2%). The most common thoracic CT findings were bilateral lung involvement (27.5%), lower lobe involvement (31.4%), nodular involvement (31.4%), and ground-glass opacity (37.3%). In the 6-12 age group, middle lobe involvement was significantly more frequent (p=0.041). The rate of consolidation significantly decreased with the increasing age (p=0.045).
Conclusion: The most common CT findings were bilateral, peripheral lower lobe involvement in pediatric COVID-19 cases. Consolidation was the most frequent lesion in the 0-6 age group, which can be attributed to the high incidence of bacterial co-infection. In the 12-18 age group, the distribution, morphology, and opacity of the lesions were comparable with those seen in adults. The lesions presented with nodular and ground-glass opacity patterns in the 6-12 and 12-18 age groups.

Kaynakça

  • Ye Z, Zhang Y, Wang Y, Huang Z, Song B. Chest CT manifestations of new coronavirus disease 2019 (COVID-19): a pictorial review. Eur Radiol. 2020;30(8):4381-4389. doi:10.1007/s00330-020-06801-0
  • Wang W, Tang J, Wei F. Updated understanding of the outbreak of 2019 novel coronavirus (2019-nCoV) in Wuhan, China. J Med Virol. 2020;92(4):441-447. doi:10.1002/jmv.25689
  • Lu X, Zhang L, Du H, et al. SARS-CoV-2 Infection in Children. N Engl J Med. 2020;382(17):1663-1665. doi:10.1056/NEJMc2005073
  • Blumfield E, Levin TL. COVID-19 in pediatric patients: a case series from the Bronx, NY. Pediatr Radiol. 2020;50(10):1369-1374. doi:10.1007/s00247-020-04782-2
  • Qiu H, Wu J, Hong L, Luo Y, Song Q, Chen D. Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: an observational cohort study. Lancet Infect Dis. 2020;20(6):689-696. doi:10.1016/S1473-3099(20)30198-5
  • Shi T, McAllister DA, O'Brien KL, et al. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015: a systematic review and modelling study. Lancet. 2017;390(10098):946-958. doi:10.1016/S0140-6736(17)30938-8
  • Meissner HC. Viral Bronchiolitis in Children. N Engl J Med. 2016;374(1):62-72. doi:10.1056/NEJMra1413456
  • Rubin GD, Ryerson CJ, Haramati LB, et al. The Role of Chest Imaging in Patient Management During the COVID-19 Pandemic: A Multinational Consensus Statement From the Fleischner Society. Chest. 2020;158(1):106-116. doi:10.1016/j.chest.2020.04.003
  • Bao C, Liu X, Zhang H, Li Y, Liu J. Coronavirus Disease 2019 (COVID-19) CT Findings: A Systematic Review and Meta-analysis. J Am Coll Radiol. 2020;17(6):701-709. doi:10.1016/j.jacr.2020.03.006
  • Zhu J, Zhong Z, Li H, et al. CT imaging features of 4121 patients with COVID-19: A meta-analysis. J Med Virol. 2020;92(7):891-902. doi:10.1002/jmv.25910
  • Wan S, Li M, Ye Z, et al. CT Manifestations and Clinical Characteristics of 1115 Patients with Coronavirus Disease 2019 (COVID-19): A Systematic Review and Meta-analysis. Acad Radiol. 2020;27(7):910-921. doi:10.1016/j.acra.2020.04.033
  • Cao Y, Liu X, Xiong L, Cai K. Imaging and clinical features of patients with 2019 novel coronavirus SARS-CoV-2: A systematic review and meta-analysis. J Med Virol. 2020;92(9):1449-1459. doi:10.1002/jmv.25822
  • Hansell DM, Bankier AA, MacMahon H, McLoud TC, Müller NL, Remy J. Fleischner Society: glossary of terms for thoracic imaging. Radiology. 2008;246(3):697-722. doi:10.1148/radiol.2462070712
  • Kanne JP. Chest CT Findings in 2019 Novel Coronavirus (2019-nCoV) Infections from Wuhan, China: Key Points for the Radiologist. Radiology. 2020;295(1):16-17. doi:10.1148/radiol.2020200241
  • Shen K, Yang Y, Wang T, et al. Diagnosis, treatment, and prevention of 2019 novel coronavirus infection in children: experts' consensus statement. World J Pediatr. 2020;16(3):223-231. doi:10.1007/s12519-020-00343-7
  • Ludvigsson JF. Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults. Acta Paediatr. 2020;109(6):1088-1095. doi:10.1111/apa.15270
  • Nino G, Zember J, Sanchez-Jacob R, Gutierrez MJ, Sharma K, Linguraru MG. Pediatric lung imaging features of COVID-19: A systematic review and meta-analysis. Pediatr Pulmonol. 2021;56(1):252-263. doi:10.1002/ppul.25070
  • Restrepo-Gualteros SM, Gutierrez MJ, Villamil-Osorio M, Arroyo MA, Nino G. Challenges and Clinical Implications of the Diagnosis of Cytomegalovirus Lung Infection in Children. Curr Infect Dis Rep. 2019;21(7):24. Published 2019 May 30. doi:10.1007/s11908-019-0681-x
  • Mansoor A, Perez G, Nino G, Linguraru MG. Automatic tissue characterization of air trapping in chest radiographs using deep neural networks. Annu Int Conf IEEE Eng Med Biol Soc. 2016;2016:97-100. doi:10.1109/EMBC.2016.7590649
  • Okada K, Golbaz M, Mansoor A, et al. Severity quantification of pediatric viral respiratory illnesses in chest X-ray images. Annu Int Conf IEEE Eng Med Biol Soc. 2015;2015:165-168. doi:10.1109/EMBC.2015.7318326
  • Arroyo M, Salka K, Perez GF, et al. Phenotypical Sub-setting of the First Episode of Severe Viral Respiratory Infection Based on Clinical Assessment and Underlying Airway Disease: A Pilot Study. Front Pediatr. 2020;8:121. Published 2020 Apr 2. doi:10.3389/fped.2020.00121
  • Varga Z, Flammer AJ, Steiger P, et al. Endothelial cell infection and endotheliitis in COVID-19. Lancet. 2020;395(10234):1417-1418. doi:10.1016/S0140-6736(20)30937-5
  • Xia W, Shao J, Guo Y, Peng X, Li Z, Hu D. Clinical and CT features in pediatric patients with COVID-19 infection: Different points from adults. Pediatr Pulmonol. 2020;55(5):1169-1174. doi:10.1002/ppul.24718
  • Foust AM, Phillips GS, Chu WC, et al. International Expert Consensus Statement on Chest Imaging in Pediatric COVID-19 Patient Management: Imaging Findings, Imaging Study Reporting, and Imaging Study Recommendations. Radiol Cardiothorac Imaging. 2020;2(2):e200214. Published 2020 Apr 23. doi:10.1148/ryct.2020200214
  • Bayramoglu Z, Canıpek E, Comert RG, et al. Imaging Features of Pediatric COVID-19 on Chest Radiography and Chest CT: A Retrospective, Single-Center Study. Acad Radiol. 2021;28(1):18-27. doi:10.1016/j.acra.2020.10.002
  • Katal S, Johnston SK, Johnston JH, Gholamrezanezhad A. Imaging Findings of SARS-CoV-2 Infection in Pediatrics: A Systematic Review of Coronavirus Disease 2019 (COVID-19) in 850 Patients. Acad Radiol. 2020;27(11):1608-1621. doi:10.1016/j.acra.2020.07.031
  • Deng Q, Ou C, Chen J, Xiang Y. Particle deposition in tracheobronchial airways of an infant, child and adult. Sci Total Environ. 2018;612:339-346. doi:10.1016/j.scitotenv.2017.08.240
  • Ugas-Charcape CF, Ucar ME, Almanza-Aranda J, et al. Pulmonary imaging in coronavirus disease 2019 (COVID-19): a series of 140 Latin American children. Pediatr Radiol. 2021;51(9):1597-1607. doi:10.1007/s00247-021-05055-2
  • Li K, Wu J, Wu F, et al. The Clinical and Chest CT Features Associated With Severe and Critical COVID-19 Pneumonia. Invest Radiol. 2020;55(6):327-331. doi:10.1097/RLI.0000000000000672
Toplam 29 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular İç Hastalıkları
Bölüm Orijinal Araştırma
Yazarlar

Hilal Gülsm Turan Özsoy 0000-0003-2021-6311

Behiye Oral 0000-0002-9952-4140

İsa Kılıç 0000-0002-0764-5982

Erken Görünüm Tarihi 31 Ağustos 2023
Yayımlanma Tarihi 31 Ağustos 2023
Kabul Tarihi 20 Haziran 2023
Yayımlandığı Sayı Yıl 2023

Kaynak Göster

EndNote Turan Özsoy HG, Oral B, Kılıç İ (01 Ağustos 2023) Covid-19’lu Pediatrik Vakalardaki Toraks Tomografisi Bulgularının Yaşlara Göre Dağılımı , Thoracic computed tomography findings of pediatric COVID-19 cases according to age groups. Ege Tıp Bilimleri Dergisi 6 2 48–55.

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