TY - JOUR
T1 - Coronavirus disease 2019 (COVID-19) in children
T2 - a systematic review of imaging findings
AU - Collaborators of the European Society of Paediatric Radiology Cardiothoracic Imaging Taskforce
AU - Shelmerdine, Susan C.
AU - Lovrenski, Jovan
AU - Caro-Domínguez, Pablo
AU - Toso, Seema
AU - Alexopoulou, Efi
AU - Almanza, Judith
AU - Calder, Alistair D.
AU - Ciet, Pierluigi
AU - Damasio, Beatrice
AU - Desoky, Sarah M.
AU - Gomez-Pastrana, David
AU - Goo, Hyun Woo
AU - Gorkem, Sureyya Burcu
AU - Hirsch, Franz Wolfgang
AU - Kellenberger, Christian
AU - Mahani, Maryam Ghadimi
AU - Navallas, Maria
AU - Owens, Catherine M.
AU - Raissaki, Maria
AU - Riaza, Lucia
AU - van Rijn, Rick R.
AU - van Schuppen, Joost
AU - Secinaro, Aurelio
AU - Toma, Paolo
AU - Ugas Charcape, Carlos S.
N1 - Publisher Copyright:
© 2020, The Author(s).
PY - 2020/8/1
Y1 - 2020/8/1
N2 - Background: COVID-19 is a novel coronavirus infection that can cause a severe respiratory illness and has been declared a pandemic by the World Health Organization (WHO). Because children appear to be less severely affected than adults, their imaging appearances have not been extensively reported. Objective: To systematically review available literature regarding imaging findings in paediatric cases of COVID-19. Materials and methods: We searched four databases (Medline, Embase, Cochrane, Google Scholar) for articles describing imaging findings in children with COVID-19. We included all modalities, age <18 years, and foreign language articles, using descriptive statistics to identify patterns and locations of imaging findings, and their association with outcomes. Results: Twenty-two articles were included, reporting chest imaging findings in 431 children, of whom 421 (97.7%) underwent CT. Criteria for imaging were lacking. At diagnosis, 143/421 (34.0%) had a normal CT. Abnormalities were more common in the lower lobes and were predominantly unilateral. The most common imaging pattern was ground-glass opacification (159/255, 62.4%). None of the studies described lymphadenopathy, while pleural effusions were rare (three cases). Improvement at follow-up CT imaging (3–15 days later) was seen in 29/100 (29%), remained normal in 25/100 (25%) and progressed in 9/100 (9%). Conclusion: CT chest findings in children with COVID-19 are frequently normal or mild. Lower lobes are predominantly affected by patchy ground-glass opacification. Appearances at follow-up remain normal or improve in the majority of children. Chest CT imaging adds little to the further management of the patient and should be reserved for severe cases or for identifying alternative diagnoses.
AB - Background: COVID-19 is a novel coronavirus infection that can cause a severe respiratory illness and has been declared a pandemic by the World Health Organization (WHO). Because children appear to be less severely affected than adults, their imaging appearances have not been extensively reported. Objective: To systematically review available literature regarding imaging findings in paediatric cases of COVID-19. Materials and methods: We searched four databases (Medline, Embase, Cochrane, Google Scholar) for articles describing imaging findings in children with COVID-19. We included all modalities, age <18 years, and foreign language articles, using descriptive statistics to identify patterns and locations of imaging findings, and their association with outcomes. Results: Twenty-two articles were included, reporting chest imaging findings in 431 children, of whom 421 (97.7%) underwent CT. Criteria for imaging were lacking. At diagnosis, 143/421 (34.0%) had a normal CT. Abnormalities were more common in the lower lobes and were predominantly unilateral. The most common imaging pattern was ground-glass opacification (159/255, 62.4%). None of the studies described lymphadenopathy, while pleural effusions were rare (three cases). Improvement at follow-up CT imaging (3–15 days later) was seen in 29/100 (29%), remained normal in 25/100 (25%) and progressed in 9/100 (9%). Conclusion: CT chest findings in children with COVID-19 are frequently normal or mild. Lower lobes are predominantly affected by patchy ground-glass opacification. Appearances at follow-up remain normal or improve in the majority of children. Chest CT imaging adds little to the further management of the patient and should be reserved for severe cases or for identifying alternative diagnoses.
KW - Adolescents
KW - Children
KW - Computed tomography
KW - Coronavirus
KW - COVID-19
KW - Imaging
KW - Radiology
KW - Systematic review
UR - http://www.scopus.com/inward/record.url?scp=85086578942&partnerID=8YFLogxK
U2 - 10.1007/s00247-020-04726-w
DO - 10.1007/s00247-020-04726-w
M3 - Article
C2 - 32556807
AN - SCOPUS:85086578942
SN - 0301-0449
VL - 50
SP - 1217
EP - 1230
JO - Pediatric Radiology
JF - Pediatric Radiology
IS - 9
ER -