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Pediatrik COVID-19 Vakalarında Akciğer Bilgisayarlı Tomografisi Ne Kadar Değerli?

Yıl 2020, Cilt: 5 Sayı: 4, 572 - 581, 30.12.2020
https://doi.org/10.26453/otjhs.767400

Öz

Amaç: Çocuk COVID-19 olgularının akciğer tomografi, laboratuar ve klinik özelliklerini karşılaştırarak, akciğer BT’sinin tanı ve tedavideki önemini araştırmayı amaçladık.


Materyal ve Metot: Mart 2020- Nisan 2020 tarihleri arasında çocuk kliniğimizde COVID-19 şüphesi ile izlenen 45 çocuk hastanın klinik ve radyolojik bulguları , hastanemizin elektronik kayıt sisteminden elde edilerek değerlendirildi.


Bulgular: Olguların 24’ü kız, 21’i erkek ve ortanca yaş 177 aydı. Otuz iki hastanın RT-PCRsonucu pozitif, 13 hastanın negatifti. En sık görülen semptom öksürük (%87) idi. Hastaların 33’ünde temas öyküsü vardı. Olguların 30’unda COVID-19 u düşündüren göğüs BT bulguları vardı. RT-PCR sonuçları ile akciğer BT bulguları arasında anlamlı ilişki yoktu. Akciğer BT derecelendirmesi ile CRP arasında arasında anlamlı ilişki bulundu (p< 0.01).

Sonuç: Çalışmamızda çocuk olgularda göğüs BT’sinin, tanı koymada ve tedavi planlanmasında herhangi bir üstünlüğü olmadığı görülmüştür. Bu nedenle çocuklardan göğüs BT isterken radyasyonun olası hasarları düşünülerek klinik gereklilik göz önünde bulundurulmalıdır.

Destekleyen Kurum

YOK

Proje Numarası

YOK

Kaynakça

  • World Health Organization. Novel coronavirus China2020. https://www.who.int/csr/don/12-january-2020-novel-coronaviruschina/en/. Accessed 15 Feb 2020.
  • International committee on taxonomy viruses naming the 2019coronavirus2020. https://talk.ictvonline.org/. Accessed 15 Feb 2020.
  • World Health Organization. Novel coronavirus (2019-nCoV) situation report – 222020. https://www.who.int/docs/default-source/ coronaviruse/situation-reports. /20200211-sitrep-22-ncov.pdf?sfvrsn= fb6d49b1_2. Accessed 15 Feb 2020.
  • World Health Organization. Novel coronavirus (2019-nCoV) situation report – 1172020. https://www.who.int/docs/default–source/coronaviruse/situation–reports. Accessed 16 May 2020.
  • Yasuhara J, Kuno T, Takagi H, Sumitomo N. Clinical characteristics of COVID-19 in children: A systematic review. Pediatr Pulmonol. 2020;55:2565–2575.
  • Tagarro A, Epalza C, Santos M, et al. Screening and severity of Coronavirus Disease 2019 (COVID-19) in Children in Madrid, Spain. JAMA Pediatr. 2020. doi:10.1001/jamapediatrics.2020.1346
  • Korean Society of Infectious D, Korean Society of Pediatric Infectious D, Korean Society of E, et al. Report on the Epidemiological Features of Coronavirus Disease 2019 (COVID-19) Outbreak in the Republic of Korea from January 19 to March 2, 2020. J Korean Med Sci. 2020;35: e112.
  • Dong Y, Mo X, Hu Y, et al. Epidemiology of COVID-19 among children in China. Pediatrics. 2020. doi:10.1542/peds.2020–0702
  • Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382:1708–1720.
  • British Society of Thoracic Imaging. Thoracic Imaging in COVID 19 Infection Guidance for the Reporting Radiologist Version 2.2020 https://www.bsti.org.uk/standards-clinical-guidelines/clinical-guidelines/bsti-covid-19-guidance-for-the-reporting-radiologist/. Accessed 20 May 2020.
  • Centers for Disease Control and Prevention (CDC).Coronavirus Disease 2019 in Children COVID-19 Response Team. MMWR Morb Mortal Wkly Rep. 2020;69(14):422 .
  • Ma H, Hu J, Tian J, et al. A single-center, retrospective study of COVID-19 features in children: a descriptive investigation. BMC Med. 2020;18(1):123. doi:10.1186/s12916-020-01596-9
  • 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
  • Li Y, Cao J, Zhang X, et al. Chest CT imaging characteristics of COVID-19 pneumonia in preschool children: a retrospective study. BMC Pediatr. 2020;20(1):227. doi:10.1186/s12887-020-02140-7
  • Lu Y, Wen H, Rong D, Zhou Z, Liu H. Clinical characteristics and radiological features of children infected with the 2019 novel coronavirus. Clin Radiol. 2020;75(7):520-525. doi:10.1016/j.crad.2020.04.010
  • Zheng F, Liao C, Fan QH et al. Clinical characteristics of children with coronavirus disease 2019 in Hubei, China. Curr Med Sci. 2020;24:1-6. doi:10.1007/s11596-020-2172-6
  • Jonker FA, Boele van Hensbroek M. Anaemia, iron deficiency and susceptibility to infections. J Infect. 2014;69 Supp l1:S23-7.
  • Merkus PJ, Klein WM. Value of Chest CT as COVID 19 screening tool in children. Eur Respir J. 2020;2001241. doi:10.1183/13993003.01241-2020
  • Xie X, Zhong Z, Zhao W, Zheng C, Wang F, Liu J. Chest CT for typical 2019-nCoV pneumonia: relationship to negative RT-PCR testing. Radiology. 2020;296:41-45. doi:10.1148/radiol.2020200343
  • Fang Y, Zhang H, Xie J, et al. Sensitivity of Chest CT for COVID-19: Comparison to RT-PCR. Radiology. 2020;296:115-197. doi:10.1148/radiol.2020200432
  • Chen Z, Fu J, Shu Q, et al. Diagnosis and treatment recommendation for pediatric coronavirus disease-19. Zhejiang Da Xue Xue Bao Yi Xue Ban. 2020;49(1):1–8.
  • DuanY, Zhu Y, Tang L, et al. CT features of novel coronavirus pneumonia (COVID-19) in children. EurRadiol. 2020;14:1-7. doi:10.1007/s00330-020-06860-3
  • Li HJ, Liu SY, Xu HB, Cheng JL. Guideline for medical imaging in auxiliary diagnosis of coronavirus disease 2019. Chin J Med Imaging Technol. 2020;36:1–11.
  • Zhou Y, Yang GD, Feng K, et al. Clinical features and chest CT findings of coronavirus disease 2019 in infants and young children. Zhongguo Dang Dai Er Ke Za Zhi. 2020;22(3):215-220. doi:10.1016/j.inf.2020.03.007
  • Liua H , Liub F, Li J, Zhanga T, Wanga D, Lanb W. Clinical and CT Imaging Features of the COVID-19 Pneumonia: Focus on Pregnant Women and Children. The Journal of Infection. 2020;80(5):7-13. doi:10.1016/j.jinf.2020.03.007
  • Feng K, Yun YX, Wang XF, et al. Analysis of CT features of 15 children with 2019 novel coronavirus infection. Zhonghua Er Ke Za Zhi. 2020;58(0):E007. doi:10.3760/cma.j.issn.0578-1310.2020.0007
  • Koo HJ, Lim S, Choe J, Choi SH, Sung H, Do KH. Radiographic and CT Features of Viral Pneumonia. Radiographics. 2018;38(3):719–39.
  • Wang D, Ju XL, Xie F, et al. Clinical analysis of 31 cases of 2019 novel coronavirus infection in children from six provinces (autonomous region) of northern China. Chin J Pediatr. 2020;58(4):269-274. doi:10.3760/cma.j.cn112140-20200225-00138
  • Li W, Cui H, Li K, Fang Y, Li S. Chest computed tomography in children with COVID-19 respiratory infection. Pediatr Radiol. 2020;50(6):796-799. doi:10.1007/s00247-020-04656-7

How Valuable is ChestComputed Tomography in Pediatric Patients with Coronavirus Disease 2019?

Yıl 2020, Cilt: 5 Sayı: 4, 572 - 581, 30.12.2020
https://doi.org/10.26453/otjhs.767400

Öz

Objective: We aimed to investigate the importance of chest CT in diagnosis and treatment of pediatric patients with COVID-19 by comparing chest CT, laboratory, and clinical features.

Materials and Methods: The clinical and image findings of 45 children with suspected COVID-19 , addmited to our pediatric clinic between March and April ,2020 were obtained from hospital electronic records.


Results: The median age of children was 177 months, while 24 of the patients were female and 21 were male. RT-PCR results of 32 children were positive and of 13 were negative. The most common symptom was cough (87%). Thirty-three of the patients had a history of contact with an infected person. Chest CT images of the 30 cases suggested COVID-19. There was no significant relationship between RT-PCR results and chest CT findings. A significant correlation was found between chest CT severity and CRP (p <0.01).

Conclusion: In our study, it was observed that chest CT does not have any advantage in diagnosis and treatment planning in pediatric cases. Therefore, considering the radiation exposure associated with CT scan, physicians should beware of clinical symptoms in children.

Proje Numarası

YOK

Kaynakça

  • World Health Organization. Novel coronavirus China2020. https://www.who.int/csr/don/12-january-2020-novel-coronaviruschina/en/. Accessed 15 Feb 2020.
  • International committee on taxonomy viruses naming the 2019coronavirus2020. https://talk.ictvonline.org/. Accessed 15 Feb 2020.
  • World Health Organization. Novel coronavirus (2019-nCoV) situation report – 222020. https://www.who.int/docs/default-source/ coronaviruse/situation-reports. /20200211-sitrep-22-ncov.pdf?sfvrsn= fb6d49b1_2. Accessed 15 Feb 2020.
  • World Health Organization. Novel coronavirus (2019-nCoV) situation report – 1172020. https://www.who.int/docs/default–source/coronaviruse/situation–reports. Accessed 16 May 2020.
  • Yasuhara J, Kuno T, Takagi H, Sumitomo N. Clinical characteristics of COVID-19 in children: A systematic review. Pediatr Pulmonol. 2020;55:2565–2575.
  • Tagarro A, Epalza C, Santos M, et al. Screening and severity of Coronavirus Disease 2019 (COVID-19) in Children in Madrid, Spain. JAMA Pediatr. 2020. doi:10.1001/jamapediatrics.2020.1346
  • Korean Society of Infectious D, Korean Society of Pediatric Infectious D, Korean Society of E, et al. Report on the Epidemiological Features of Coronavirus Disease 2019 (COVID-19) Outbreak in the Republic of Korea from January 19 to March 2, 2020. J Korean Med Sci. 2020;35: e112.
  • Dong Y, Mo X, Hu Y, et al. Epidemiology of COVID-19 among children in China. Pediatrics. 2020. doi:10.1542/peds.2020–0702
  • Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382:1708–1720.
  • British Society of Thoracic Imaging. Thoracic Imaging in COVID 19 Infection Guidance for the Reporting Radiologist Version 2.2020 https://www.bsti.org.uk/standards-clinical-guidelines/clinical-guidelines/bsti-covid-19-guidance-for-the-reporting-radiologist/. Accessed 20 May 2020.
  • Centers for Disease Control and Prevention (CDC).Coronavirus Disease 2019 in Children COVID-19 Response Team. MMWR Morb Mortal Wkly Rep. 2020;69(14):422 .
  • Ma H, Hu J, Tian J, et al. A single-center, retrospective study of COVID-19 features in children: a descriptive investigation. BMC Med. 2020;18(1):123. doi:10.1186/s12916-020-01596-9
  • 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
  • Li Y, Cao J, Zhang X, et al. Chest CT imaging characteristics of COVID-19 pneumonia in preschool children: a retrospective study. BMC Pediatr. 2020;20(1):227. doi:10.1186/s12887-020-02140-7
  • Lu Y, Wen H, Rong D, Zhou Z, Liu H. Clinical characteristics and radiological features of children infected with the 2019 novel coronavirus. Clin Radiol. 2020;75(7):520-525. doi:10.1016/j.crad.2020.04.010
  • Zheng F, Liao C, Fan QH et al. Clinical characteristics of children with coronavirus disease 2019 in Hubei, China. Curr Med Sci. 2020;24:1-6. doi:10.1007/s11596-020-2172-6
  • Jonker FA, Boele van Hensbroek M. Anaemia, iron deficiency and susceptibility to infections. J Infect. 2014;69 Supp l1:S23-7.
  • Merkus PJ, Klein WM. Value of Chest CT as COVID 19 screening tool in children. Eur Respir J. 2020;2001241. doi:10.1183/13993003.01241-2020
  • Xie X, Zhong Z, Zhao W, Zheng C, Wang F, Liu J. Chest CT for typical 2019-nCoV pneumonia: relationship to negative RT-PCR testing. Radiology. 2020;296:41-45. doi:10.1148/radiol.2020200343
  • Fang Y, Zhang H, Xie J, et al. Sensitivity of Chest CT for COVID-19: Comparison to RT-PCR. Radiology. 2020;296:115-197. doi:10.1148/radiol.2020200432
  • Chen Z, Fu J, Shu Q, et al. Diagnosis and treatment recommendation for pediatric coronavirus disease-19. Zhejiang Da Xue Xue Bao Yi Xue Ban. 2020;49(1):1–8.
  • DuanY, Zhu Y, Tang L, et al. CT features of novel coronavirus pneumonia (COVID-19) in children. EurRadiol. 2020;14:1-7. doi:10.1007/s00330-020-06860-3
  • Li HJ, Liu SY, Xu HB, Cheng JL. Guideline for medical imaging in auxiliary diagnosis of coronavirus disease 2019. Chin J Med Imaging Technol. 2020;36:1–11.
  • Zhou Y, Yang GD, Feng K, et al. Clinical features and chest CT findings of coronavirus disease 2019 in infants and young children. Zhongguo Dang Dai Er Ke Za Zhi. 2020;22(3):215-220. doi:10.1016/j.inf.2020.03.007
  • Liua H , Liub F, Li J, Zhanga T, Wanga D, Lanb W. Clinical and CT Imaging Features of the COVID-19 Pneumonia: Focus on Pregnant Women and Children. The Journal of Infection. 2020;80(5):7-13. doi:10.1016/j.jinf.2020.03.007
  • Feng K, Yun YX, Wang XF, et al. Analysis of CT features of 15 children with 2019 novel coronavirus infection. Zhonghua Er Ke Za Zhi. 2020;58(0):E007. doi:10.3760/cma.j.issn.0578-1310.2020.0007
  • Koo HJ, Lim S, Choe J, Choi SH, Sung H, Do KH. Radiographic and CT Features of Viral Pneumonia. Radiographics. 2018;38(3):719–39.
  • Wang D, Ju XL, Xie F, et al. Clinical analysis of 31 cases of 2019 novel coronavirus infection in children from six provinces (autonomous region) of northern China. Chin J Pediatr. 2020;58(4):269-274. doi:10.3760/cma.j.cn112140-20200225-00138
  • Li W, Cui H, Li K, Fang Y, Li S. Chest computed tomography in children with COVID-19 respiratory infection. Pediatr Radiol. 2020;50(6):796-799. doi:10.1007/s00247-020-04656-7
Toplam 29 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makalesi
Yazarlar

Aysun Boga 0000-0002-9574-9529

Nurettin Yiyit Bu kişi benim 0000-0003-1671-7498

Umut Ergül Bu kişi benim 0000-0003-2090-9222

Neşe Ergül Bu kişi benim 0000-0002-2665-5326

Kemal Pişmişoğlu Bu kişi benim 0000-0001-7278-309X

Taha Yusuf Kuzan 0000-0002-5420-8507

Murat Cihan 0000-0001-6611-7226

Şirin Güven 0000-0001-8727-5805

Halit Cam 0000-0002-2611-9515

Proje Numarası YOK
Yayımlanma Tarihi 30 Aralık 2020
Gönderilme Tarihi 10 Temmuz 2020
Kabul Tarihi 1 Ekim 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 5 Sayı: 4

Kaynak Göster

AMA Boga A, Yiyit N, Ergül U, Ergül N, Pişmişoğlu K, Kuzan TY, Cihan M, Güven Ş, Cam H. How Valuable is ChestComputed Tomography in Pediatric Patients with Coronavirus Disease 2019?. OTSBD. Aralık 2020;5(4):572-581. doi:10.26453/otjhs.767400

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