Radiological & Clinical Manifestations of COVID-19 in Children: A Review of 100 Cases

Abstract

Abstract Background Severe acute respiratory distress syndrome that was caused by SARS-CoV-2, has become a global pandemic. Aim of the Work To describe the X-ray and CT features of COVID-19 in children and to correlate a CT and X-ray based semi-quantitative scores of pulmonary involvement in COVID-19 disease with clinical severity of the disease and to correlate CT and X ray scores to investigate whether X-ray sufficient in the clinical evaluation of patients. Patients and Methods A retrospective analysis of CT and x-ray pulmonary findings of 100 case of COVID-19 was included. CT& x-ray scores were calculated and correlated to patients’ clinical severity. The study included 49 girls and 51 boys. Their mean age was 6.25 years. Results Eighty-five children had done CT chest (85%), X-ray was available in fifty eight (58 %). Both X- ray and CT were available in forty three children (43%). According to the severity of COVID-19 among patients, 31 % of the patients were mild, 40% were moderate, 18 % were severe and 11% were critically ill. On CT, we found that consolidation patches were the most common radiological sign seen in 41.2% of the patients, followed by GGO which was found in 37.6% of the patients. The lesions were bilateral (40%), and multilobar (44.7%), predominant lobes affected were both lower lobes involved in 42.4 %, with a prominent peripheral distribution. Regarding the X-ray, the alveolar infiltrate in the form of GGO was the most common feature seen in 32.7% of the patients with predominant bilateral lower zones distribution (58.7 %). Cases with clinically severe and critically ill chest condition had a statistically significant higher CT and X-ray scores compared to other groups. (p value = <0.001 for CT score, p value=0.009 for x-ray score). X-ray score correlates to CT score (p value <0.001, r = 0.62). D dimer had a significant correlation with total CT score (p value=0.022). Conclusion X-ray score correlates to CT score. CT and X-ray scores are correlated to clinical severity. To reduce radiation exposure, X-ray may be sufficient in assessment of COVID-19.