Abstract
Objective: This work aims to investigate the clinical features and the temporal changes of RT-PCR and CT in COVID-19 pediatric patients.Methods: The clinical, RT-PCR, and CT features of 114 COVID-19 pediatric in-patients were retrospectively reviewed from January 21 to March 14, 2020. All patients had chest CT on admission and were identified as positive by pharyngeal swab nucleic acid test. The clinical features were analyzed, as well as the features and the temporal changes of RT-PCR and CT.Results: Fever (62, 54%) and cough (61, 54%) were the most common symptoms. There were 34 (30%) cases of concurrent infections. The most common imaging features on CT were ground-glass opacities (46, 40%) and consolidation (46, 40%). The bilateral lower lobes were the most common pattern of involvement, with 63 cases (55%) involving one to two lobes, and in 32 (28%) cases CT was normal. Throughout the whole duration of COVID-19 in children, the diagnostic positive rate of RT-PCR has been far higher than that of CT (all P < 0.05). For RT-PCR follow-up, reliable negative results were obtained only 7 days after the onset of symptoms. Though lung involvement on chest CT progressed rapidly in several cases, lung involvement in children with COVID-19 is mild, with a median value of 2 on CT score.Conclusions: RT-PCR is more reliable than CT in the initial diagnosis of pediatric patients with COVID-19. On follow-up, reliable negative RT-PCR results are available 7 days after the initial symptoms. The use of CT should be considered for follow-up purposes only if necessary.
Highlights
Since December 2019, a newly discovered infectious disease named COVID-19, caused by a novel coronavirus (SARS-CoV-2), has wildly spread worldwide
Viral nucleic acid testing and chest CT have been considered as the main diagnostic methods for patients with suspected COVID-19 pneumonia
We reviewed the clinical charts of all the pediatric patients for demographic information, symptoms, date of symptom onset, admission date, discharge date, and dates and results of nucleic acid tests for COVID-19 and other identified concurrent infectious pathogens
Summary
Since December 2019, a newly discovered infectious disease named COVID-19, caused by a novel coronavirus (SARS-CoV-2), has wildly spread worldwide. Viral nucleic acid testing and chest CT have been considered as the main diagnostic methods for patients with suspected COVID-19 pneumonia. Despite the possibility of false positives, the positive rate of chest CT is significantly higher than that of RT-PCR and is considered a more accurate early diagnostic tool [6,7,8,9]. For pediatric patients with suspected COVID-19, studies on chest CT values are limited [2, 10]. Some studies have suggested that normal CT or lack of typical features were not uncommon in pediatric patients, especially during the early stage of the disease [11,12,13,14]. The use of CT should be carefully assessed since pediatric patients are sensitive to radiation, and reducing CT scans for children is a top priority
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