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1.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-323066

ABSTRACT

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 virus), which resulted in the worldwide COVID-19 pandemic of 2020, has particularly affected Latin America. Objective: The purpose of the study was to analyze the imaging findings of pulmonary COVID-19 in a large pediatric series. Materials: and methods: Children with confirmed SARS-CoV-2 infection confirmed by either quantitative reverse transcription-polymerase chain reaction from nasopharyngeal swabs or presence of circulating IgM and/or IgG antibodies and who underwent chest radiograph (CXR) and/or computed tomography (CT) were included in this retrospective multicenter study. Three pediatric radiologists independently reviewed CXRs and CTs to identify the presence, localization, distribution and extension of pulmonary lesions. Results: : One hundred and forty children (71 female;median age 6.2 years;interquartile range 1.6-12.1 years) were included in the study. Peribronchial thickening (93%), ground glass opacities (79%) and vascular engorgement (63%) were the most frequent findings on 131 CXRs. Ground glass opacities (91%), vascular engorgement (84%) and peribronchial thickening (72%) were the most frequent findings on 32 CTs. Peribronchial thickening (100%), ground-glass opacities (90%) and pulmonary vascular engorgement (74%) were common CXR findings in asymptomatic patients (n=20). Consolidation and ground-glass opacity were significantly higher in patients who needed ICU admission or expired, in contrast with patients with a good outcome (48% and 91%, vs 24% and 70% p<0.05, respectively). Conclusion: Asymptomatic children and those with mild symptoms of COVID-19 showed mainly peribronchial thickening, ground-glass opacities and pulmonary vascular engorgement on CXRs. Ground glass opacity and consolidation, were more common in patients who required ICU admission or died.

2.
Pediatr Radiol ; 51(9): 1608-1620, 2021 08.
Article in English | MEDLINE | ID: covidwho-1202740

ABSTRACT

BACKGROUND: A hyperinflammatory immune-mediated shock syndrome has been recognised in children exposed to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19). OBJECTIVE: To describe typical imaging findings in children with multisystem inflammatory syndrome associated with COVID-19. MATERIALS AND METHODS: During the first wave of the COVID-19 pandemic, imaging studies and clinical data from children treated for multisystem inflammatory syndrome were collected from multiple centres. Standardised case templates including demographic, biochemical and imaging information were completed by participating centres and reviewed by paediatric radiologists and paediatricians. RESULTS: We included 37 children (21 boys; median age 8.0 years). Polymerase chain reaction (PCR) testing was positive for SARS-CoV-2 in 15/37 (41%) children and immunoglobulins in 13/19 children (68%). Common clinical presentations were fever (100%), abdominal pain (68%), rash (54%), conjunctivitis (38%) and cough (32%). Thirty-three children (89%) showed laboratory or imaging findings of cardiac involvement. Thirty of the 37 children (81%) required admission to the intensive care unit, with good recovery in all cases. Chest radiographs demonstrated cardiomegaly in 54% and signs of pulmonary venous hypertension/congestion in 73%. The most common chest CT abnormalities were ground-glass and interstitial opacities (83%), airspace consolidation (58%), pleural effusion (58%) and bronchial wall thickening (42%). Echocardiography revealed impaired cardiac function in half of cases (51%) and coronary artery abnormalities in 14%. Cardiac MRI showed myocardial oedema in 58%, pericardial effusion in 42% and decreased left ventricular function in 25%. Twenty children required imaging for abdominal symptoms, the commonest abnormalities being free fluid (71%) and terminal ileum wall thickening (57%). Twelve children underwent brain imaging, showing abnormalities in two cases. CONCLUSION: Children with multisystem inflammatory syndrome showed pulmonary, cardiac, abdominal and brain imaging findings, reflecting the multisystem inflammatory disease. Awareness of the imaging features of this disease is important for early diagnosis and treatment.


Subject(s)
COVID-19/diagnostic imaging , Lung/diagnostic imaging , SARS-CoV-2/isolation & purification , Tomography, X-Ray Computed/methods , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19 Nucleic Acid Testing , Child , Child, Preschool , Echocardiography , Female , Humans , Magnetic Resonance Imaging , Male , Pandemics , SARS-CoV-2/genetics , Systemic Inflammatory Response Syndrome
3.
Pediatr Radiol ; 51(9): 1597-1607, 2021 08.
Article in English | MEDLINE | ID: covidwho-1162998

ABSTRACT

BACKGROUND: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which resulted in the worldwide coronavirus disease 2019 (COVID-19) pandemic of 2020, has particularly affected Latin America. OBJECTIVE: The purpose of the study was to analyze the imaging findings of pulmonary COVID-19 in a large pediatric series. MATERIALS AND METHODS: Children with SARS-CoV-2 infection confirmed by either quantitative reverse transcription-polymerase chain reaction from nasopharyngeal swabs or presence of circulating immunoglobulin M (IgM) antibodies and who underwent chest radiograph or CT or both were included in this retrospective multicenter study. Three pediatric radiologists independently reviewed radiographs and CTs to identify the presence, localization, distribution and extension of pulmonary lesions. RESULTS: We included 140 children (71 female; median age 6.3 years, interquartile range 1.6-12.1 years) in the study. Peribronchial thickening (93%), ground-glass opacities (79%) and vascular engorgement (63%) were the most frequent findings on 131 radiographs. Ground-glass opacities (91%), vascular engorgement (84%) and peribronchial thickening (72%) were the most frequent findings on 32 CTs. Peribronchial thickening (100%), ground-glass opacities (83%) and pulmonary vascular engorgement (79%) were common radiograph findings in asymptomatic children (n=25). Ground-glass opacity and consolidation were significantly higher in children who needed intensive care admission or died (92% and 48%), in contrast with children with a favorable outcome (71% and 24%, respectively; P<0.05). CONCLUSION: Asymptomatic children and those with mild symptoms of COVID-19 showed mainly peribronchial thickening, ground-glass opacities and pulmonary vascular engorgement on radiographs. Ground-glass opacity and consolidation were more common in children who required intensive care admission or died.


Subject(s)
COVID-19/diagnosis , Lung/diagnostic imaging , SARS-CoV-2/isolation & purification , Tomography, X-Ray Computed/methods , Adult , COVID-19/epidemiology , COVID-19 Nucleic Acid Testing , Child , Child, Preschool , Female , Humans , Infant , Latin America , Male , Mexico/epidemiology , Retrospective Studies , SARS-CoV-2/genetics
4.
Rev Peru Med Exp Salud Publica ; 37(4): 689-693, 2020.
Article in Spanish, English | MEDLINE | ID: covidwho-1076943

ABSTRACT

The aim of the study was to describe the clinical and epidemiological characteristics of children with COVID-19. We analyzed the clinical records of inpatients and outpatients of the Instituto Nacional de Salud del Niño San Borja from the period between March and May, 2020. A total of 33 patients were registered, 57.6% were males with a median age of 4.8 years (range: 2 months - 17 years). We found that 81.8% of the children had contact with a positive COVID-19 case, 60.6% had concomitant diseases, 93.9% presented symptoms (mainly fever and cough) and the median incubation period was 7 days. The hemogram and acute-phase reactants were normal in most cases. Chest X-ray was abnormal in 11/16 patients. All patients received supportive treatment; 2 patients required supplemental oxygen. One patient died from complications associated with a terminal phase brain tumor. We report the clinical and epidemiological characteristics of children with COVID-19 during the first months of the pandemic in Peru.


Con el objetivo de conocer las características clínicas y epidemiológicas de niños con COVID-19, se evaluaron las historias clínicas de pacientes atendidos de manera ambulatoria y en hospitalización del Instituto Nacional de Salud del Niño San Borja de marzo a mayo de 2020. Se registraron 33 pacientes, 57,6% fueron varones con mediana de edad de 4,8 años (rango: 2 meses - 17 años). El 81,8% tuvo contacto epidemiológico y la mediana del periodo de incubación fue siete días. El 60,6% tuvieron enfermedades concomitantes; el 93,9% presentó síntomas, los más comunes fueron fiebre y tos. El hemograma y los reactantes de fase aguda fueron normales en la mayoría de los casos. La radiografía de tórax fue anormal en 11/16 pacientes. El manejo fue de soporte, dos pacientes requirieron oxígeno suplementario. Un paciente falleció por complicaciones asociadas a una tumoración cerebral en fase terminal. Se reporta las caracteristicas clinicas y epidemiologicas en niños con COVID-19 durante los primeros meses de la pandemia en Perú.


Subject(s)
COVID-19/epidemiology , Cough/epidemiology , Fever/epidemiology , Adolescent , COVID-19/therapy , Child , Child, Preschool , Cough/virology , Female , Fever/virology , Hospitals, Pediatric , Humans , Infant , Male , Peru/epidemiology , Retrospective Studies
5.
Pediatr Radiol ; 50(10): 1354-1368, 2020 09.
Article in English | MEDLINE | ID: covidwho-693835

ABSTRACT

BACKGROUND: Pulmonary infection with SARS-CoV-2 virus (severe acute respiratory syndrome coronavirus 2; COVID-19) has rapidly spread worldwide to become a global pandemic. OBJECTIVE: To collect paediatric COVID-19 cases worldwide and to summarize both clinical and imaging findings in children who tested positive on polymerase chain reaction testing for SARS-CoV-2. MATERIALS AND METHODS: Data were collected by completion of a standardised case report form submitted to the office of the European Society of Paediatric Radiology from March 12 to April 8, 2020. Chest imaging findings in children younger than 18 years old who tested positive on polymerase chain reaction testing for SARS-CoV-2 were included. Representative imaging studies were evaluated by multiple senior paediatric radiologists from this group with expertise in paediatric chest imaging. RESULTS: Ninety-one children were included (49 males; median age: 6.1 years, interquartile range: 1.0 to 13.0 years, range: 9 days-17 years). Most had mild symptoms, mostly fever and cough, and one-third had coexisting medical conditions. Eleven percent of children presented with severe symptoms and required intensive unit care. Chest radiographs were available in 89% of patients and 10% of them were normal. Abnormal chest radiographs showed mainly perihilar bronchial wall thickening (58%) and/or airspace consolidation (35%). Computed tomography (CT) scans were available in 26% of cases, with the most common abnormality being ground glass opacities (88%) and/or airspace consolidation (58%). Tree in bud opacities were seen in 6 of 24 CTs (25%). Lung ultrasound and chest magnetic resonance imaging were rarely utilized. CONCLUSION: It seems unnecessary to perform chest imaging in children to diagnose COVID-19. Chest radiography can be used in symptomatic children to assess airway infection or pneumonia. CT should be reserved for when there is clinical concern to assess for possible complications, especially in children with coexisting medical conditions.


Subject(s)
Betacoronavirus , Coronavirus Infections/diagnostic imaging , Pneumonia, Viral/diagnostic imaging , Radiography, Thoracic/methods , Tomography, X-Ray Computed/methods , Adolescent , COVID-19 , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Lung/diagnostic imaging , Male , Pandemics , Reproducibility of Results , Retrospective Studies , SARS-CoV-2
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