tetano
Editor, Senior Moderator
Pol J Radiol
. 2022 Mar 2;87:e126-e140.
doi: 10.5114/pjr.2022.114505. eCollection 2022.
Diagnostic performance of chest computed tomography for COVID-19 in children: a systematic review and meta-analysis of clinical and computed tomography features in 987 patients
Mahitab Ghoneim[SUP] 1 [/SUP], Riham Eid[SUP] 1 [/SUP], Nashwa Hamdy[SUP] 1 [/SUP], Doaa Shokry[SUP] 1 [/SUP], Mohammed A Salem[SUP] 1 [/SUP], Ahmed El-Morsy[SUP] 1 [/SUP], Ali H Elmokadem[SUP] 1 [/SUP]
Affiliations
Abstract
Purpose: The outbreak of a new coronavirus is still spreading worldwide, affecting children and adults. However, COVID-19 in children shows distinctive characteristics in clinical and radiological presentation. We aimed to assess the diagnostic performance of chest CT and clarify the clinicoradiological CT features of COVID-19 among children with COVID-19.
Material and methods: Adhering to PRISMA-DTA guidelines, we searched databases (PubMed, Google Scholar, and Web of Science) to identify relevant articles. The search keywords were: "Chest CT" AND "COVID-19" OR "coronavirus" OR "SARS-COV-2" AND "Children" OR "Pediatric". Published reports providing clinical and imaging findings of paediatric COVID-19 were included.
Results: Twenty-eight studies were included, with 987 patients. Most of the patients were symptomatic (76.9%; 95% CI: 69.2-84.7%), with fever being the most frequent manifestation (64%; 95% CI: 58.0-71.2%). Only 2.3% of the cases were critical, and mortality was reported in one case. The proportion of COVID-19 detected by chest CT among children is relatively high (658/987), with ground-glass opacity (GGO) being the most prevalent feature (52.5%; 95% CI: 40.5-64.7%). The pooled sensitivity of chest CT in all patients was 67%; however, it was different between symptomatic and asymptomatic patients (71% and 33%, respectively). The pooled specificity was (67%), which was calculated after considering the symptomatic PCR-positive patients as the gold standard.
Conclusions: Chest CT showed moderate pooled sensitivity and specificity among symptomatic children with COVID-19 and low sensitivity among asymptomatic children. This means that CT is not to be used as a screening tool or for confirmation of the diagnosis in children and should be reserved for specific clinical situations.
Keywords: COVID-19; SARS-CoV-2; chest CT; children; coronavirus; diagnostic performance.
. 2022 Mar 2;87:e126-e140.
doi: 10.5114/pjr.2022.114505. eCollection 2022.
Diagnostic performance of chest computed tomography for COVID-19 in children: a systematic review and meta-analysis of clinical and computed tomography features in 987 patients
Mahitab Ghoneim[SUP] 1 [/SUP], Riham Eid[SUP] 1 [/SUP], Nashwa Hamdy[SUP] 1 [/SUP], Doaa Shokry[SUP] 1 [/SUP], Mohammed A Salem[SUP] 1 [/SUP], Ahmed El-Morsy[SUP] 1 [/SUP], Ali H Elmokadem[SUP] 1 [/SUP]
Affiliations
- PMID: 35505860
- PMCID: PMC9047799
- DOI: 10.5114/pjr.2022.114505
Abstract
Purpose: The outbreak of a new coronavirus is still spreading worldwide, affecting children and adults. However, COVID-19 in children shows distinctive characteristics in clinical and radiological presentation. We aimed to assess the diagnostic performance of chest CT and clarify the clinicoradiological CT features of COVID-19 among children with COVID-19.
Material and methods: Adhering to PRISMA-DTA guidelines, we searched databases (PubMed, Google Scholar, and Web of Science) to identify relevant articles. The search keywords were: "Chest CT" AND "COVID-19" OR "coronavirus" OR "SARS-COV-2" AND "Children" OR "Pediatric". Published reports providing clinical and imaging findings of paediatric COVID-19 were included.
Results: Twenty-eight studies were included, with 987 patients. Most of the patients were symptomatic (76.9%; 95% CI: 69.2-84.7%), with fever being the most frequent manifestation (64%; 95% CI: 58.0-71.2%). Only 2.3% of the cases were critical, and mortality was reported in one case. The proportion of COVID-19 detected by chest CT among children is relatively high (658/987), with ground-glass opacity (GGO) being the most prevalent feature (52.5%; 95% CI: 40.5-64.7%). The pooled sensitivity of chest CT in all patients was 67%; however, it was different between symptomatic and asymptomatic patients (71% and 33%, respectively). The pooled specificity was (67%), which was calculated after considering the symptomatic PCR-positive patients as the gold standard.
Conclusions: Chest CT showed moderate pooled sensitivity and specificity among symptomatic children with COVID-19 and low sensitivity among asymptomatic children. This means that CT is not to be used as a screening tool or for confirmation of the diagnosis in children and should be reserved for specific clinical situations.
Keywords: COVID-19; SARS-CoV-2; chest CT; children; coronavirus; diagnostic performance.