CT Severity Scoring Index and Chest Radiography findings in COVID-19 cases in Pediatric and Adolescent age group- A Retrospective analysis

Abstract

Background: The initial cases of novel corona virus reported in Wuhan city in December 2019. Then it became global outbreak. The World Health Organization (WHO) on March 11, 2020, declared the novel coronavirus (COVID-19) outbreak a global pandemic[1,2]. The disease had spread to more than 150 countries around the world and the death number has constantly increased. Most of pediatric patients were initially asymptomatic. Transmission in children is critical problem. Radiological manifestation varies between age group. We aimed to determine radiographic chest finding in pediatric COVID-19 in tertiary Centre. Aim: To evaluate CT Severity Scoring Index and Chest X Ray findings in COVID-19 cases in Pediatric and Adolescent age group. Methods: 54 patients of pediatric and adolescent age (up to ≤18yrs) with RT-PCR positive who were admitted in our tertiary centre were retrospectively included in this study. CT scan and chest radiographic data of the patients were collected from medical records. The data was summarized. The CT chest and chest radiographic pattern of COVID 19 positive in pediatric and adolescent age group of ≤ 18yrs were analyzed. Results: 54 patients were admitted in our hospital with COVID-19during study time. CT chest was done in 42 patients and Chest radiograph was done in all 54 patients. Characteristic CT findings were ground-glass opacities or consolidation and combination of both. Ground-glass opacities 15/21 (71.4%) were more often encountered in our study, and when consolidation opacities were identified, they were most of time accompanied by a ground-glass opacity 5/21(23.8%). Chest radiograph finding was ground glass opacity. Lower lobes were most commonly involved in both modalities. Female and male patients were infected with equal frequency. Apart from above pattern in CT, linear opacity, crazy paving pattern, halo sign and reverse halo sign also noted in some patients. Majority of patients showed peripheral distribution of opacities. Conclusion: This review of available studies of COVID-19 pneumonia in pediatric patients provides insight into CT imaging findings of the disease in this specific population. The most common CT and Chest radiographic findings were ground-glass opacities typically with lower-lobe predominance. Our findings were matching with previous studies. Severe category of lung involvement was seen in few case but had full recovery. Chest CT can be employed in the early diagnosis and management of selected symptomatic pediatric patients, if clinically warranted.