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J Trop Pediatr . Radiological Findings of COVID-19 in Children: A Systematic Review and Meta-Analysis

tetano

Editor, Senior Moderator
J Trop Pediatr


. 2020 Jul 21;fmaa045.
doi: 10.1093/tropej/fmaa045. Online ahead of print.
Radiological Findings of COVID-19 in Children: A Systematic Review and Meta-Analysis


Jogender Kumar[SUP] 1 [/SUP], Jitendra Meena[SUP] 2 [/SUP], Arushi Yadav[SUP] 3 [/SUP], Jaivinder Yadav[SUP] 1 [/SUP]



Affiliations

Abstract

Background: The majority of the children with SARS-CoV-2 infection present with respiratory symptoms, hence various chest imaging modalities have been used in the management. Knowledge about the radiological findings of coronavirus disease (COVID-19) in children is limited. Hence, we systematically synthesized the available data that will help in better management of COVID-19 in children.
Methods: Four different electronic databases (MEDLINE, EMBASE, Web of Science and CENTRAL) were searched for articles reporting radiological findings in children with COVID-19. Studies reporting thoracic radiological findings of COVID-19 in patients aged <19 years were included. A random-effect meta-analysis (wherever feasible) was performed to provide pooled estimates of various findings.
Results: A total of 1984 records were screened of which forty-six studies (923 patients) fulfilled the eligibility criteria and were included in this systematic review. A chest computed tomography (CT) scan was the most frequently used imaging modality. While one-third of the patients had normal scans, a significant proportion (19%) of clinically asymptomatic children had radiological abnormalities too. Unilateral lung involvement (55%) was frequent when compared with bilateral and ground-glass opacities were the most frequent (40%) definitive radiological findings. Other common radiological findings were non-specific patchy shadows (44%), consolidation (23%), halo sign (26%), pulmonary nodules and prominent bronchovascular marking. Interstitial infiltration being the most frequent lung ultrasound finding.
Conclusion: CT scan is the most frequently used imaging modality for COVID-19 in children and can detect pneumonia before the appearance of clinical symptoms. Undefined patchy shadows, grand-glass opacities and consolidation are commonly observed imaging findings in COVID-19 pneumonia.

Keywords: COVID-19; computed tomography; ground-glass opacity; imaging; lung ultrasound; pneumonia.
 
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