Relationship of chest computed tomography score with disease severity and laboratory values in children with COVID-19.

AIM: Although chest computed tomography (CT) score has been well evaluated in adult coronavirus disease (COVID-19), its use in paediatric cases is insufficiently studied. Our aim is to evaluate the relationship of chest CT score with disease severity and laboratory parameters. METHODS: Seventy-six paediatric patients with confirmed COVID-19 and chest CT evaluation on admission have been included in this study. Chest CT score was calculated for each of the five lobes considering the extent of anatomical involvement, as follows: 0: 0%; 1: <5%; 2: 5%-25%; 3: 26%-50%; 4: 51%-75% and 5: >75%. The resulting total CT score was the sum of each individual lobar score; the range was between 0 and 25. RESULTS: Total chest CT score was found to be positively correlated with alanine aminotransferase and d-dimer, and negatively correlated with lymphocyte count. In receiver operating characteristic analysis, total chest CT score had area under the curve 0.99 (95% confidence interval, 0.98-1.00) at cut-off 2 with 95% sensitivity and 96% specificity for the severe disease. Furthermore, in-depth analysis of lobar CT scores showed a correlation between left upper lobe with lymphocyte count, left lower lobe with d-dimer, right middle and lower lobes with alanine aminotransferase and right upper lobe with leukocyte count. CONCLUSIONS: There is a significant relationship between chest CT score and COVID-19 severity and laboratory findings in children. This suggests that chest CT scores can be used to assess the severity of the disease and can play an important role in paediatric clinical practice.

Correlation of neuroimaging and thorax CT findings in patients with COVID-19: A large single-center experience

Background/aim: The aim of this current study was to describe the neuroimaging findings among patients with COVID-19 and to compare them with thorax CT imaging findings and clinicobiological profiles. Materials and methods: Between the period March 11 and December 31, 2020, we evaluated brain computed tomography (CT) and magnetic resonance (MR) images of patients with COVID-19. A total of 354 patients (mean age 65.2 ± 16.6, 52% female, 42% male) who had brain imaging were included in the study. Of this total sample, 218 had thorax CT scanning (65.5%). Neuroimaging and thorax CT findings, clinical course, neurologic findings, and laboratory data were evaluated. White matter lesions (WML) and thorax CT scans were scored. Participants were divided according to whether or not they had an infarction. Results: The neuroimaging findings indicated infarcts, parenchymal hemorrhage, encephalitis, cortical signal abnormality, posterior reversible encephalopathy syndrome (PRES), and cranial nerve involvement. WML significantly positively correlated with age (p < 0.01) but not with sex (p > 0.05). Thorax CT findings did not demonstrate significant correlations with infarcts, WML, or hemorrhages (p> 0.05). D-dimer and ferritin levels were significantly higher among patients with infarcts (p < 0.05). Conclusion: Immune-mediated prothrombic state and cytokine storm appear to be more responsible for etiopathogenesis than direct viral neurotropism. Neuroimaging and thorax CT findings were not correlated among patients with COVID-19 in our study. These results suggest that neurological manifestations may occur independently of pulmonary involvement and age.

Should CT be used for the diagnosis of RT-PCR-negative suspected COVID-19 patients?

INTRODUCTION: The diagnosis of patients with Coronavirus disease 2019 (COVID-19) suspicion but negative reverse transcriptase-polymerase chain reaction (RT-PCR) test is challenging. OBJECTIVE: We aimed to investigate the diagnostic value of chest computed tomography (CT) in RT-PCR-negative patients with suspected COVID-19. MATERIALS AND METHODS: The study included patients who were admitted to our hospital with the suspicion of COVID-19 between 1 April 2020 and 30 April 2020 and tested negative after RT-PCR test, and underwent CT for further diagnosis. Initial CT findings were classified as typical, indeterminate, and atypical for COVID-19, and negative for pneumonia. Incidental findings on CT were noted. RESULTS: Of the 338 patients with a mean age of 57 years (min 18 years-max 96 years), 168 (49.70%) were male and 170 (50.29%) were female. The most common symptoms were cough (58.87%), fever (40.82%), and dyspnea (39.34%). The CT findings were typical for COVID-19 in 109 (32.24%) patients, indeterminate in 47 (13.90%) patients, and atypical in 77 (22.78%) patients. The CT findings of 105 (31.06%) patients were negative for pneumonia. Incidental lung nodules suspicious of malignancy were identified in seven patients. Seventy-seven patients (22.78%) had extrapulmonary incidental findings CONCLUSION: The diagnostic value of CT in RT-PCR-negative patients with suspected COVID-19 is not very high. Based on clinical, laboratory, and chest x-ray findings, it may be more appropriate to refer patients to CT after the first triage, when necessary.

The Efficacy of Chest Computed Tomography in Pediatric Patients With Suspected COVID-19.

OBJECTIVE: The aim of the study was to investigate chest computed tomography (CT) findings and the value of CT in the diagnosis in children with suspected coronavirus disease 2019 (COVID-19). MATERIALS AND METHODS: Chest CT images of pediatric patients with suspected COVID-19 were retrospectively evaluated. Computed tomography findings were divided into 3 groups: normal, consistent, and inconsistent with COVID-19. The sensitivity and specificity of CT were calculated by reference to reverse transcriptase polymerase chain reaction. RESULTS: The study included patients with a mean age of 11.1 years (1 month-17 years). Of the patients, 43 (40.19%) had normal CT, 34 (31.77%) had CT findings consistent with COVID-19, and 30 (28.04%) had CT findings inconsistent with COVID-19. The sensitivity, specificity, positive predictive value, and negative predictive value of CT were 47.92%, 81.36%, 67.65%, and 65.75%, respectively. CONCLUSIONS: Because the sensitivity of CT in the pediatric age group is low, it should be used cautiously for the evaluation of COVID-19 in the pediatric age group.