The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 virus), which resulted in the worldwide COVID-19 pandemic of 2020, has particularly affected Latin America.
The purpose of the study was to analyze the imaging findings of pulmonary COVID-19 in a large pediatric series.
Materials and methods:
Children with confirmed SARS-CoV-2 infection confirmed by either quantitative reverse transcription-polymerase chain reaction from nasopharyngeal swabs or presence of circulating IgM and/or IgG antibodies and who underwent chest radiograph (CXR) and/or computed tomography (CT) were included in this retrospective multicenter study. Three pediatric radiologists independently reviewed CXRs and CTs to identify the presence, localization, distribution and extension of pulmonary lesions.
One hundred and forty children (71 female; median age 6.2 years; interquartile range 1.6-12.1 years) were included in the study. Peribronchial thickening (93%), ground glass opacities (79%) and vascular engorgement (63%) were the most frequent findings on 131 CXRs. Ground glass opacities (91%), vascular engorgement (84%) and peribronchial thickening (72%) were the most frequent findings on 32 CTs. Peribronchial thickening (100%), ground-glass opacities (90%) and pulmonary vascular engorgement (74%) were common CXR findings in asymptomatic patients (n=20). Consolidation and ground-glass opacity were significantly higher in patients who needed ICU admission or expired, in contrast with patients with a good outcome (48% and 91%, vs 24% and 70% p<0.05, respectively).
Asymptomatic children and those with mild symptoms of COVID-19 showed mainly peribronchial thickening, ground-glass opacities and pulmonary vascular engorgement on CXRs. Ground glass opacity and consolidation, were more common in patients who required ICU admission or died.