Clinical and imaging features of pediatric COVID-19

Ital J Pediatr. 2020 Oct 14;46(1):153. doi: 10.1186/s13052-020-00917-1.

Abstract

Background: Pediatric COVID-19 is relatively mild and may vary from that in adults. This study was to investigate the epidemic, clinical, and imaging features of pediatric COVID-19 pneumonia for early diagnosis and treatment.

Methods: Forty-one children infected with COVID-19 were analyzed in the epidemic, clinical and imaging data.

Results: Among 30 children with mild COVID-19, seven had no symptoms, fifteen had low or mediate fever, and eight presented with cough, nasal congestion, diarrhea, headache, or fatigue. Among eleven children with moderate COVID-19, nine presented with low or mediate fever, accompanied with cough and runny nose, and two had no symptoms. Significantly (P < 0.05) more children had a greater rate of cough in moderate than in mild COVID-19. Thirty children with mild COVID-19 were negative in pulmonary CT imaging, whereas eleven children with moderate COVID-19 had pulmonary lesions, including ground glass opacity in ten (90.9%), patches of high density in six (54.5%), consolidation in three (27.3%), and enlarged bronchovascular bundles in seven (63.6%). The lesions were distributed along the bronchus in five patients (45.5%). The lymph nodes were enlarged in the pulmonary hilum in two patients (18.2%). The lesions were presented in the right upper lobe in two patients (18.1%), right middle lobe in one (9.1%), right lower lobe in six (54.5%), left upper lobe in five (45.5%), and left lower lobe in eight (72.7%).

Conclusions: Children with COVID-19 have mild or moderate clinical and imaging presentations. A better understanding of the clinical and CT imaging helps ascertaining those with negative nucleic acid and reducing misdiagnosis rate for those with atypical and concealed symptoms.

Keywords: COVID-19; Children; Epidemic; Imaging; Novel coronavirus pneumonia; SARS-CoV-2.

MeSH terms

  • Adolescent
  • Betacoronavirus*
  • COVID-19
  • Child
  • Child, Preschool
  • Coronavirus Infections / diagnosis*
  • Coronavirus Infections / epidemiology
  • Diagnostic Errors
  • Female
  • Humans
  • Infant
  • Lung / diagnostic imaging*
  • Male
  • Pandemics*
  • Pneumonia, Viral / diagnosis*
  • Pneumonia, Viral / epidemiology
  • SARS-CoV-2
  • Tomography, X-Ray Computed / methods*