Clinical features and high-resolution chest computerized tomography findings of children infected by the B.1.617.2 variant of coronavirus disease 2019

Ann Med. 2022 Dec;54(1):2391-2401. doi: 10.1080/07853890.2022.2114608.

Abstract

Purpose: To analyse the clinical symptoms, laboratory examinations and chest CT findings of children infected by the B.1.617.2 variant of COVID-19 and to compare the differences between clinical subtypes.

Methods: Fifty-three children (28 males, 25 females; age ranging from 4 months to 17 years) were included with B.1.617.2 variant infection in Nanjing, China, from July 21 to August 12 2021. Clinical data from patients were collected and analysed in groups of mild and common types. Imaging data were divided into three stages for evaluation: early, intermediate and late stages.

Results: In our study, fever (53%), cough (34%) and pharyngeal discomfort (28%) were the main symptoms. There were no differences in clinical symptoms between the mild and common type. The most common laboratory test items outside the normal range were decreased mean corpuscular volume (68%), lymphocyte percentage (64% elevated and 2% decreased) and decreased serum alkaline phosphatase concentration (66%). The differences in haemoglobin and monocyte percentages between the mild and common types were statistically significant (p = .037 and .033, respectively). No influencing factor was statistically significant in the regression analysis of both symptoms and clinical subtypes. The main CT findings were ground-glass opacity and consolidation located in the periphery and bilateral multilobed involvement. The mean CT score was 1.6. CT score correlated with packet cell volume, haemoglobin, mean erythrocyte volume, mean platelet volume and platelet distribution width.

Conclusion: The pathogenetic condition of children with B.1.617.2 variant infection is mild. Although there were intergroup differences in some blood cell analyses, T-lymphocyte counts, and comprehensive biochemical indicators, no factors had a significant effect on clinical typing and the presence or absence of symptoms. CT findings and CT scores reflect disease stage and pathological changes and correlate moderately with laboratory tests, making them of good value for disease diagnosis and monitoring.Key MessagesPaediatric patients infected with B.1.617.2 variant have a milder clinical and imaging presentation than adults and are similar to the prototype infection.CT findings and scores which reflect disease stages and pathological changes.There is a correlation between chest CT and laboratory tests, which can be useful for the diagnosis and follow-up of the disease.

Keywords: B.1.617.2 (Delta) variant; COVID-19; CT; chest.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • COVID-19* / diagnostic imaging
  • Child
  • Female
  • Fever
  • Humans
  • Lung / diagnostic imaging
  • Male
  • Retrospective Studies
  • SARS-CoV-2
  • Tomography, X-Ray Computed

Supplementary concepts

  • SARS-CoV-2 variants

Grants and funding

This work was supported by National Natural Science Foundation of China [grant number 81971573]; Suzhou Gusu Medical Youth Talent [grant number GSWS2020019]; Key Research and Development Program of Department of Health of Jiangsu [ZDB2020036]; Scientific Program of Nanjing Science and Technology Council [ZX20200009]; Project of Nanjing Infectious Disease Clinical Medical Centre Construction [NA2021062071]; Project of Nanjing Medical Science and Technology Development [ZKX20032]; Key R&D Program of Jiangsu Province (Social Development) [BE2021603].