tetano
Editor, Senior Moderator
Radiologia
. 2021 Jan 19;S0033-8338(20)30181-8.
doi: 10.1016/j.rx.2020.11.008. Online ahead of print.
Pediatric chest X-rays during the COVID-19 pandemic
[Article in En, Spanish]
E Aguirre Pascual[SUP] 1 [/SUP], D Coca Robinot[SUP] 2 [/SUP], C Gallego Herrero[SUP] 2 [/SUP], M Navallas Irujo[SUP] 2 [/SUP], M Rasero Ponferrada[SUP] 2 [/SUP], M Pont Vilalta[SUP] 2 [/SUP]
Affiliations
Abstract
Background: An infectious disease caused by a new type of coronavirus that can manifest as an acute respiratory infection was discovered in China in mid-December 2019 and soon spread throughout the country and to the rest of the world. Although chest X-rays are the initial imaging technique of choice for low respiratory infections with or without dyspnea, few articles have reported the radiologic findings in children with COVID-19.
Objective: To describe the clinical, laboratory, and chest X-ray findings in pediatric patients with signs and symptoms of respiratory infection attended at our hospital in March 2020. To analyze the frequency of COVID-19 compared to other respiratory infections, and to describe the radiologic manifestations of COVID-19 in pediatric patients.
Material and methods: This cross-sectional observational study included all children with clinical manifestations of respiratory infection (fever, rhinorrhea, cough, and/or dyspnea) that required chest X-rays in our hospital between March 1 and March 31.
Results: A total of 231 pediatric patients (90 (39%) girls and 141 (61%) boys; mean age, 4 y, range 1 month - 16 years) underwent chest X-rays for suspected respiratory infections. Most (88.4%) had mild symptoms; 29.9% had a family member positive for COVID-19 with symptoms similar to those of the patient. Nasal and/or throat swabs were analyzed for SARS-CoV-2 with PCR in the 47 (20.3%) children who presented at the emergency department; 3 (6.3%) of these were positive. Microbiological analyses were done in 85 (36.8%) of all patients, finding infections due to pathogens other than SARS-CoV-2 in 30 (35.3%). One of the patients with a PCR positive for SARS-CoV-2 had urine infection due to E. coli and blood culture positive for S. viridans. Abnormalities were observed on X-rays in 73.2% of the patients. Peribronchial thickening was the most common abnormal finding, observed in 57% of patients. Parenchymal consolidations were observed in 38.5%, being bilateral in 29.2% and associated with pleural effusion in 3.3%. The interstitial lines were thickened in 7.3%, and 7.3% had ground-glass opacities.
Conclusion: During March 2020, COVID-19 and other symptomatic respiratory infections were observed. The radiologic pattern of these infections is nonspecific, and chest X-rays alone are insufficient for the diagnosis. Children with clinical manifestations compatible with COVID-19 (with or without PCR confirmation of infection by SARS-CoV-2) had mild symptoms and most did not require admission or invasive mechanical ventilation. In a context of community transmission, the absence of a known epidemiological antecedent should not be a contraindication for PCR to detect SARS-CoV-2.
Keywords: COVID-19; Chest X-ray; Children; Infecci?n respiratoria; Ni?os; Radiograf?a de t?rax; Respiratory infection; SARS-CoV-2.
. 2021 Jan 19;S0033-8338(20)30181-8.
doi: 10.1016/j.rx.2020.11.008. Online ahead of print.
Pediatric chest X-rays during the COVID-19 pandemic
[Article in En, Spanish]
E Aguirre Pascual[SUP] 1 [/SUP], D Coca Robinot[SUP] 2 [/SUP], C Gallego Herrero[SUP] 2 [/SUP], M Navallas Irujo[SUP] 2 [/SUP], M Rasero Ponferrada[SUP] 2 [/SUP], M Pont Vilalta[SUP] 2 [/SUP]
Affiliations
- PMID: 33483143
- PMCID: PMC7817389
- DOI: 10.1016/j.rx.2020.11.008
Abstract
Background: An infectious disease caused by a new type of coronavirus that can manifest as an acute respiratory infection was discovered in China in mid-December 2019 and soon spread throughout the country and to the rest of the world. Although chest X-rays are the initial imaging technique of choice for low respiratory infections with or without dyspnea, few articles have reported the radiologic findings in children with COVID-19.
Objective: To describe the clinical, laboratory, and chest X-ray findings in pediatric patients with signs and symptoms of respiratory infection attended at our hospital in March 2020. To analyze the frequency of COVID-19 compared to other respiratory infections, and to describe the radiologic manifestations of COVID-19 in pediatric patients.
Material and methods: This cross-sectional observational study included all children with clinical manifestations of respiratory infection (fever, rhinorrhea, cough, and/or dyspnea) that required chest X-rays in our hospital between March 1 and March 31.
Results: A total of 231 pediatric patients (90 (39%) girls and 141 (61%) boys; mean age, 4 y, range 1 month - 16 years) underwent chest X-rays for suspected respiratory infections. Most (88.4%) had mild symptoms; 29.9% had a family member positive for COVID-19 with symptoms similar to those of the patient. Nasal and/or throat swabs were analyzed for SARS-CoV-2 with PCR in the 47 (20.3%) children who presented at the emergency department; 3 (6.3%) of these were positive. Microbiological analyses were done in 85 (36.8%) of all patients, finding infections due to pathogens other than SARS-CoV-2 in 30 (35.3%). One of the patients with a PCR positive for SARS-CoV-2 had urine infection due to E. coli and blood culture positive for S. viridans. Abnormalities were observed on X-rays in 73.2% of the patients. Peribronchial thickening was the most common abnormal finding, observed in 57% of patients. Parenchymal consolidations were observed in 38.5%, being bilateral in 29.2% and associated with pleural effusion in 3.3%. The interstitial lines were thickened in 7.3%, and 7.3% had ground-glass opacities.
Conclusion: During March 2020, COVID-19 and other symptomatic respiratory infections were observed. The radiologic pattern of these infections is nonspecific, and chest X-rays alone are insufficient for the diagnosis. Children with clinical manifestations compatible with COVID-19 (with or without PCR confirmation of infection by SARS-CoV-2) had mild symptoms and most did not require admission or invasive mechanical ventilation. In a context of community transmission, the absence of a known epidemiological antecedent should not be a contraindication for PCR to detect SARS-CoV-2.
Keywords: COVID-19; Chest X-ray; Children; Infecci?n respiratoria; Ni?os; Radiograf?a de t?rax; Respiratory infection; SARS-CoV-2.