The utility of a chest radiograph in screening COVID-19 patients in a pediatric tertiary government hospital
The Philippine Children&rsquo
;
s Medical Center Journal;(2): 23-41, 2022.
Artigo
em Inglês
| WPRIM
| ID: wpr-960245
ABSTRACT
@#<p><strong>Background:
</strong> Coronavirus disease 2019 (COVID-19) continues to be a pandemic to this time, and chest radiography has been used as a first-line triage tool, due to long turnaround times for real-time reverse transcription polymerase chain reaction (RT-PCR), which remains to be the gold standard in COVID-19 diagnosis. Chest x-ray alone has poor sensitivity to diagnosing COVID-19 and pediatric studies on this are scarce.</p><p><strong>Objectives:
</strong> The main objective is to evaluate the usefulness of a routine chest radiograph as an adjunct to diagnosing suspected pediatric COVID-19, along with its sensitivity, specificity, accuracy, and correlation with the most common pediatric signs and symptoms. In line with this, the radiographic characteristics seen in pediatric COVID-19 patients are presented.</p><p><strong>Methods:
</strong> A cross-sectional study involving a retrospective chart review of 259 pediatric patients admitted in a tertiary hospital with COVID-19 signs and symptoms, with baseline chest x-ray and SARS-CoV2 RT-PCR tests. Correlation of signs and symptoms with chest x-ray findings to RT-PCR positivity was determined using univariate and multivariate logistic regression analysis.</p><p><strong>Results:
</strong> The study was composed of 259 pediatric patients (ages 0-18 years old). Of these, 35 had positive findings with RT-PCR (15%). Sensitivity of a chest radiograph with pneumonia is at 62.9%, while specificity is at 39.3%. Overall accuracy of CXR findings leading to RT-PCR positivity is at 42.5%. Ground glass or hazy opacities was the most common radiographic finding (45.5%), followed by reticular opacities (31.8%). Abnormalities were mostly distributed in the inner lung zone distribution with bilateral lung involvement (90%). Those with difficulty of breathing were more likely to have pneumonia on their CXR, though a finding of pneumonia on CXR did not significantly correlate to a positive RT-PCR.</p><p><strong>Conclusions &Recommendations:
</strong> Findings of pneumonia on a pediatric CXR may not necessarily lead to a positive SARS-CoV2 RT-PCR, but correlating this with the patient's clinical course and symptoms may be beneficial in effective triaging of patients. Reassessment by another radiologist may provide additional strength to this study.</p>
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Programas de Rastreamento
/
Sensibilidade e Especificidade
Limite:
Criança
/
Feminino
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
The Philippine Children’s Medical Center Journal
Ano de publicação:
2022
Tipo de documento:
Artigo
Similares
MEDLINE
...
LILACS
LIS