ABSTRACT
Objective: This consideration used the computed tomography scan to investigate and evaluate relationship between COVID-19 pneumonia severity and pulmonary artery diameter, ascending aorta diameter (AAD), right and left pulmonary artery diameter (LPAD), and ratio of main pulmonary artery diameter (MPAD) to AAD in COVID-19 patients. Method(s): This retrospective and cross-sectional consideration was done on 90 confirmed COVID-19 patients. Diameter of MPAD, AAD, LPAD, and right pulmonary artery diameter was calculated on a solitary transverse section designated at extent of main pulmonic arterial trunk separation. Ratio of MPAD TO AAD was calculated by division of the values of MPAD and AAD in manual mode. Result(s): In this retrospective consideration, population was divided into groups of mild (43 patients with 42.6% males), moderate (30 patients with 36% males), and severe (17 patients with 21.3% males) pneumonia patients. Diameter of MPA in mild COVID pneumonia group had 23.8+/-3.4, moderate group had 26.7+/-4.3, and severe group had 29.9+/-3.6 (p<0.001). Diameter of AA in mild group had 28.1+/-3.7, moderate group had 31.0+/-4.2, and severe group had 34.0+/-4.2 (p < 0.001). Diameter of LPA in mild group had 16.1+/-2.0, moderate group had 17.5+/-2.1, and severe group had 19.1+/-2.0 (p < 0.001). Conclusion(s): Pneumonia severity of COVID-19 patients in severe group showed greater MPAD as compared to moderate group and then mild group patients, respectively. A chest computed tomography (CT) scan/high-resolution CT can be useful to determine the pneumonia extension evaluation, by measuring the MPAD which can provide extraprognostic information and aid doctors inpatient treatment. Copyright © 2022 The Authors.
ABSTRACT
Introduction: Studies show that children account for only 1-5% of diagnosed COVID-19 cases, they have milder disease than adults and deaths are extremely rare. The complete clinical picture of pediatric COVID-19 has not yet been fully reported or defined. Additionally, the South African pediatric population has unique clinical characteristics and risk implications and needs investigating. We aimed to characterize COVID-19 in Cape Town children. Methods: The UCT COVID-19 pediatric repository is a prospective cohort recruited via convenience sampling at 3 Western Cape Hospitals. All patients ≤ 18 years who test COVID-19 positive are eligible for inclusion in the study. Results: To date 227 participants, 56%(125/227) male with median age 2 years (IQR:0-6), have been enrolled. Only 28(12%) participants were in contact with a confirmed COVID-19 positive case, 67% of these, were first degree relatives, 28% second degree relatives and 6% health care workers. Comorbidities were present in 125(56%) participants. Of 32 recorded comorbidities, congenital heart disease (CHD), found in 7% of participants, ranked third. CHD subtypes included PDA (4), Tetralogy of Fallot (3), AVSD (2), Pulmonary atresia with VSD (2), truncus arteriosus (1), Coarctation of the Aorta (1), Congenital aortic valve stenosis (1), and ASD (1). Other cardiac comorbidities were, cardiomyopathy (2), primary pulmonary hypertension (1) and rhabdomyoma (1). On presentation 173 (76%) were symptomatic. Predominant symptoms included cough 40%, history of fever 36%, documented fever 34%, difficulty breathing 28%, and nausea or vomiting 20%. On examination, 65% had abnormal heart rates, 47% abnormal respiratory rates, 35% were in respiratory distress and 24% were hypoxic. Of the 227 patients, 169(74%) were admitted to hospital and 33 (15%) were admitted to ICU. In the ICU 79% of patients required non-invasive and 24% invasive ventilation, median length of ICU admission was 3 days (IQR:2-7.5). During admission 38(17%) patients developed COVID-19 complications: secondary infection 10%, sepsis 4%, MIS-C 2%, and myocarditis or new onset heart failure 1%) and 2(0.9%) died, including one patient with AVSD, who presented with severe pulmonary hypertension and acute heart failure post cardiac surgery. Conclusion: We present the initial findings of the UCT pediatric COVID-19 registry. We anticipate that these data will help to complete the clinical picture of COVID-19 in the South African pediatric population.