Pediatric COVID-19: Correlations between Clinical and Imaging Perspectives.

Background: Although SARS-CoV-2 infection primarily affects adults, the increasing emergence of infected pediatric patients has been recently reported. However, there is a paucity of data regarding the value of imaging in relation to the clinical severity of this pandemic emergency. Objectives: To demonstrate the relationships between clinical and radiological COVID-19 findings and to determine the most effective standardized pediatric clinical and imaging strategies predicting the disease severity. Patients and Methods. This observational study enrolled eighty pediatric patients with confirmed COVID-19 infection. The studied patients were categorized according to the disease severity and the presence of comorbidities. Patients' clinical findings, chest X-ray, and CT imaging results were analyzed. Patients' evaluations using several clinical and radiological severity scores were recorded. The relations between clinical and radiological severities were examined. Results: Significant associations were found between severe-to-critical illness and abnormal radiological findings (p = 0.009). In addition, chest X-ray score, chest CT severity score, and rapid evaluation of anamnesis, PO2, imaging disease, and dyspnea-COVID (RAPID-COVID) score were significantly higher among patients with severe infection (p < 0.001, <0.001, and 0.001) and those with comorbidities (p = 0.005, 0.002, and <0.001). Conclusions: Chest imaging of pediatric patients with COVID-19 infection may be of value during the evaluation of severe cases of infected pediatric patients and in those with underlying comorbid conditions, especially during the early stage of infection. Moreover, the combined use of specific clinical and radiological COVID-19 scores are likely to be a successful measure of the extent of disease severity.

Major determinant factors of pediatric COVID-19 severity, a single center study

BackgroundAccording to several recently published studies, pediatric Corona virus infection is mostly mild. However, a severe COVID-19 illness could occur in children, resulting in grave outcomes. Unfortunately, the data regarding the major determinants of disease progression in the pediatric population is still limited. Here, we aimed to identify the most significant risk factors associated with severe COVID-19 infection in children to predict the patients at elevated risk for serious illness.ResultsThis single-center, retrospective study enrolled eighty hospitalized children and adolescents under the age of 18 years with coronavirus type 2 infections, who were divided according to the level of clinical severity into severe and non-severe groups. Epidemiological data, clinical features, radiological findings, laboratory test results, and disease outcomes of the studied patients were collected and analyzed to demonstrate their relation to disease severity. Patients with severe illness tend to have more respiratory symptoms (97.8% vs. 79.4%, p = 0.007), cardiac affection (23 (50.0%) vs. 5 (14.7%), p = 0.001, and neurological involvement (13 (28.1%) vs. 1 (2.9%), p = 0.003). Furthermore, abnormal radiological findings and higher radiological scores were significantly more common among patients with severe disease compared to non-severe cases (p = 0.037, 0.013). In multivariable analysis, clinical scoring, abnormal coagulation function, and ICU admission were the most significant parameters for forecasting severe illness.ConclusionsWe identified the most remarkable parameters involved in the progression of severe disease in Egyptian children with COVID-19 infection, which may be implemented in anticipation of susceptible children for earlier prompt management and a better prognosis.