Differences between radiological findings of COVID-19 and non-COVID-19 infections in pediatric patients.

BACKGROUND: This study aimed to reveal the differences between coronavirus disease 2019 (COVID-19) infections and non-COVID-19 respiratory tract infections in pediatric patients. METHODS: Sixty pediatric patients admitted to the hospital between March 11, 2020 and April 15, 2020 with respiratory tract infections were evaluated retrospectively. Among them, 20 patients with reverse transcription-polymerase chain reaction (RT-PCR) tests and chest computed tomography (CT) examinations were included in the study. According to the RT-PCR test results, the patients were divided into the COVID-19 and non-COVID-19 groups. The clinical observations, laboratory results, and radiological features from the two groups were then compared. RESULTS: According to the RT-PCR test results, 12 patients were assigned to the COVID-19 group and 8 to the non-COVID-19 group. There were no significant differences between the two groups in terms of clinical or laboratory features. In terms of radiological features, the presence of bronchiectasis and peribronchial thickening was statistically significantly higher in the non-COVID-19 group (P = 0.010 and P = 0.010, respectively). CONCLUSIONS: In pediatric cases, diagnosing COVID-19 using radiological imaging methods plays an important role in determining the correct treatment approach by eliminating the possibility of other infections.

Relationship of the cycle threshold values of SARS-CoV-2 polymerase chain reaction and total severity score of computerized tomography in patients with COVID 19.

AIM: Studies analyzing viral load in COVID-19 patients and any data that compare viral load with chest computerized tomography (CT) severity are limited. This study aimed to evaluate the severity of chest CT in reverse transcriptase polymerase chain reaction (RT-PCR)-positive patients and factors associated with it. METHODOLOGY: SARS-CoV-2 RNA was extracted from nasopharyngeal swab samples by using Bio-speedy viral nucleic acid buffer. The RT-PCR tests were performed with primers and probes targeting the RdRp gene (Bioexen LTD, Turkey) and results were quantified as cycle threshold (Ct) values. Chest CT of SARS-CoV-2 RNA-positive patients (n = 730) in a period from 22 March to 20 May 2020 were evaluated. The total severity score (TSS) of chest CT ranged 0-20 and was calculated by summing up the degree of acute lung inflammation lesion involvement of each of the five lung lobes. RESULTS: Of the 284 patients who were hospitalized, 27 (9.5%) of them died. Of 236 (32.3%) patients, there were no findings on CT and 216 (91.5%) of them were outpatients (median age 35 years). TSS was significantly higher in hospitalized patients; 5.3% had severe changes. Ct values were lower among outpatients, indicating higher viral load. An inverse relation between viral load and TSS was detected in both groups. CT severity was related to age, and older patients had higher TSS (p < 0.01). CONCLUSION: Viral load was not a critical factor for hospitalization and mortality. Outpatients had considerable amounts of virus in their nasopharynx, which made them contagious to their contacts. Viral load is important in detecting early stages of COVID-19, to minimize potential spread, whereas chest CT can help identify cases requiring extensive medical care.