Computed Tomography Features of COVID-19 in Children: A Systematic Review and Meta-analysis

Objectives: To systematically analyze the chest CT imaging features of children with COVID-19 and provide references for clinical practice. Methods: We searched PubMed, Web of Science, and Embase; data published by Johns Hopkins University; and Chinese databases CNKI, Wanfang, and Chongqing Weipu. Reports on chest CT imaging features of children with COVID-19 from January 1, 2020, to August 10, 2020, were analyzed retrospectively and a meta-analysis carried out using Stata12.0 software. Results: Thirty-seven articles (1747 children) were included in this study. The overall rate of abnormal lung CT findings was 63.2% (95% confidence interval [CI]: 55.8-70.6%), with a rate of 61.0% (95% CI: 50.8-71.2%) in China and 67.8% (95% CI: 57.1-78.4%) in the rest of the world in the subgroup analysis. The incidence of ground-glass opacities was 39.5% (95% CI: 30.7-48.3%), multiple lung lobe lesions 65.1% (95% CI: 55.1-67.9%), and bilateral lung lesions 61.5% (95% CI: 58.8-72.2%). Other imaging features included nodules (25.7%), patchy shadows (36.8%), halo sign (24.8%), consolidation (24.1%), air bronchogram signs (11.2%), cord-like shadows (9.7%), crazy-paving pattern (6.1%), and pleural effusion (9.1%). Two articles reported three cases of white lung, another reported two cases of pneumothorax, and another one case of bullae. CONCLUSION: The lung CT results of children with COVID-19 are usually normal or slightly atypica, with a low sensitivity and specificity compared with that in adults. The lung lesions of COVID-19 pediatric patients mostly involve both lungs or multiple lobes, and the common manifestations are patchy shadows, ground-glass opacities, consolidation, partial air bronchogram signs, nodules, and halo signs; white lung, pleural effusion, and paving stone signs are rare. CLINICAL IMPACT: Therefore, chest CT has limited value as a screening tool for children with COVID-19 and can only be used as an auxiliary assessment tool.

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Early CT features of COVID-19 pneumonia, association with patients’ age and duration of presenting complaint

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-021-00539-5 ◽

2021 ◽

Vol 52 (1) ◽

Author(s):

Reem M. EL Kady ◽

Hosam A. Hassan ◽

Tareef S. Daqqaq ◽

Rania Makboul ◽

Hanan Mosleh Ibrahim

Keyword(s):

Pleural Effusion ◽

Ground Glass Opacity ◽

Ct Imaging ◽

Older Age ◽

Ground Glass ◽

Imaging Features ◽

Age Group ◽

Patient Age ◽

Atypical Features ◽

Patient Âgé

Abstract Background Coronavirus disease (COVID-19) is a respiratory syndrome with a variable degree of severity. Imaging is a vital component of disease monitoring and follow-up in coronavirus pulmonary syndromes. The study of temporal changes of CT findings of COVID-19 pneumonia can help in better understanding of disease pathogenesis and prediction of disease prognosis. In this study, we aim to determine the typical and atypical CT imaging features of COVID-19 and discuss the association of typical CT imaging features with the duration of the presenting complaint and patients’ age. Results The lesions showed unilateral distribution in 20% of cases and bilateral distribution in 80% of cases. The lesions involved the lower lung lobes in 30% of cases and showed diffuse involvement in 58.2% of cases. The lesions showed peripheral distribution in 74.5% of cases. The most common pattern was multifocal ground glass opacity found in 72.7% of cases. Atypical features like cavitation and pleural effusion can occur early in the disease course. There was significant association between increased number of the lesions, bilaterality, diffuse pattern of lung involvement and older age group (≥ 50 years old) and increased duration of presenting complaint (≥ 4 days). There was significant association between crazy-paving pattern and increased duration of presenting complaint. No significant association could be detected between any CT pattern and increased patient age. Conclusion The most common CT feature of COVID-19 was multifocal ground glass opacity. Atypical features like cavitation and pleural effusion can occur early in the course of the disease. Our cases showed more extensive lesions with bilateral and diffuse patterns of distribution in the older age group and with increased duration of presenting complaint. There was a significant association between crazy-paving pattern and increased duration of presenting complaint. No significant association could be detected between any CT pattern and increased patient age.

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Can CT imaging features of ground-glass opacity predict invasiveness? A meta-analysis

Thoracic Cancer ◽

10.1111/1759-7714.12604 ◽

2018 ◽

Vol 9 (4) ◽

pp. 452-458 ◽

Cited By ~ 6

Author(s):

Jian Dai ◽

Guoyou Yu ◽

Jianqiang Yu

Keyword(s):

Meta Analysis ◽

Ground Glass Opacity ◽

Ct Imaging ◽

Ground Glass ◽

Imaging Features

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Chest CT imaging features of COVID-19 and its correlation with the PaO2/FiO2 ratio: a multicenter study in Upper Egypt

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-020-00373-1 ◽

2020 ◽

Vol 51 (1) ◽

Author(s):

Noha M. Attia ◽

Moustafa H. M. Othman

Keyword(s):

Disease Severity ◽

Negative Correlation ◽

Severity Score ◽

Ct Imaging ◽

Chest Ct ◽

Ground Glass ◽

Arterial Oxygen ◽

Imaging Features ◽

Preliminary Assessment ◽

Moderate Negative Correlation

Abstract Background The main challenge in managing COVID-19 pandemic is containment of the infection by early detection of the disease and wide dissemination of diagnostic tests with high sensitivity and specificity. Various imaging features were identified by chest CT with different patterns from early disease to diffuse disease with complications. However, CT cannot be performed for all patients. The arterial oxygen partial pressure/fraction of inspired oxygen (PaO2/FiO2) ratio is evaluated as a rapid and widely available test for the preliminary assessment of disease severity. This study aimed to evaluate the clinical and chest CT imaging features of COVID-19 in Egyptian patients as well as assess the correlation between the chest CT total severity score and the PaO2/FiO2 ratio to determine its value for preliminary assessment of disease severity. Results The most common symptoms were fever (83.2%), dry cough (77%), malaise (68.8%), prolonged headaches (48.5%), and dyspnea (37.6%). CT was positive in 79.2% of the patients. The CT features at presentation were ground-glass opacities only (40%), ground-glass opacities with consolidation (34.4%), and consolidation only (25.6%). Associated findings included crazy paving (17.5%), interlobular septal thickening (47.5%), air bronchogram (15%), bronchiectasis (12.8%), fibrous bands (8.1%), vascular enlargement within the lesion (45.6%), nodules (6.8%), pericardial thickening (5%), and pleural thickening (24.7%). The lesions were typically multilobar (50.5%), posterior (58.1%) with peripheral and central distribution (41.9%). Moderate negative correlation was observed between the CT total lung severity score and PaO2/FiO2 ratio with r = − 0.42 and P < 0.001. Conclusion The most common pattern of COVID-19 pneumonia in multiple quarantine hospitals was peripheral and central ground-glass opacities with bilateral multilobe posterior involvement and fever was the most common symptom. PaO2/FiO2 ratio has a moderate negative correlation with the CT total severity score and thus can be used in the preliminary assessment of disease severity.

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Computed Tomography (CT) Imaging Features of Patients with COVID-19: Systematic Review and Meta-Analysis

Radiology Research and Practice ◽

10.1155/2020/1023506 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8 ◽

Cited By ~ 3

Author(s):

Ephrem Awulachew ◽

Kuma Diriba ◽

Asrat Anja ◽

Eyob Getu ◽

Firehiwot Belayneh

Keyword(s):

Ground Glass Opacity ◽

Ct Imaging ◽

Chest Ct ◽

Ground Glass ◽

Cochrane Library ◽

Imaging Features ◽

Severe Respiratory Distress ◽

Ct Findings ◽

Open Access Journals ◽

Bilateral Lung

Introduction. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly contagious disease, and its first outbreak was reported in Wuhan, China. A coronavirus disease (COVID-19) causes severe respiratory distress (ARDS). Due to the primary involvement of the respiratory system, chest CT is strongly recommended in suspected COVID-19 cases, for both initial evaluation and follow-up. Objective. The aim of this review was to systematically analyze the existing literature on CT imaging features of patients with COVID-19 pneumonia. Methods. A systematic search was conducted on PubMed, Embase, Cochrane Library, Open Access Journals (OAJ), and Google Scholar databases until April 15, 2020. All articles with a report of CT findings in COVID-19 patients published in English from the onset of COVID-19 outbreak to April 20, 2020, were included in the study. Result. From a total of 5041 COVID-19-infected patients, about 98% (4940/5041) had abnormalities in chest CT, while about 2% have normal chest CT findings. Among COVID-19 patients with abnormal chest CT findings, 80% (3952/4940) had bilateral lung involvement. Ground-glass opacity (GGO) and mixed GGO with consolidation were observed in 2482 (65%) and 768 (18%) patients, respectively. Consolidations were detected in 1259 (22%) patients with COVID-19 pneumonia. CT images also showed interlobular septal thickening in about 691 (27%) patients. Conclusion. Frequent involvement of bilateral lung infections, ground-glass opacities, consolidation, crazy paving pattern, air bronchogram signs, and intralobular septal thickening were common CT imaging features of patients with COVID-19 pneumonia.

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Chest CT : Imaging and Reading of the Lung CT in the Radiological(Interpreting Medical Images for Radiological Technologists)

Japanese Journal of Radiological Technology ◽

10.6009/jjrt.kj00003943060 ◽

2005 ◽

Vol 61 (8) ◽

pp. 1059-1072

Author(s):

ISAO YAMAGUCHI

Keyword(s):

Medical Images ◽

Ct Imaging ◽

Chest Ct ◽

Lung Ct

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Prevalence of COVID-19 Diagnostic Output with Chest Computed Tomography: A Systematic Review and Meta-Analysis

Diagnostics ◽

10.3390/diagnostics10121023 ◽

2020 ◽

Vol 10 (12) ◽

pp. 1023

Author(s):

Temitope Emmanuel Komolafe ◽

John Agbo ◽

Ebenezer Obaloluwa Olaniyi ◽

Kayode Komolafe ◽

Xiaodong Yang

Keyword(s):

Computed Tomography ◽

Meta Analysis ◽

Age Groups ◽

Disease Prevalence ◽

Chest Ct ◽

Imaging Features ◽

Rt Pcr ◽

Chest Computed Tomography ◽

Pooled Prevalence ◽

History Of

Background: The pooled prevalence of chest computed tomography (CT) abnormalities and other detailed analysis related to patients’ biodata like gender and different age groups have not been previously described for patients with coronavirus disease 2019 (COVID-19), thus necessitating this study. Objectives: To perform a meta-analysis to evaluate the diagnostic performance of chest CT, common CT morphological abnormalities, disease prevalence, biodata information, and gender prevalence of patients. Methods: Studies were identified by searching PubMed and Science Direct libraries from 1 January 2020 to 30 April 2020. Pooled CT positive rate of COVID-19 and RT-PCR, CT-imaging features, history of exposure, and biodata information were estimated using the quality effect (QE) model. Results: Out of 36 studies included, the sensitivity was 89% (95% CI: 80–96%) and 98% (95% CI: 90–100%) for chest CT and reverse transcription-polymerase chain reaction (RT-PCR), respectively. The pooled prevalence across lesion distribution were 72% (95% CI: 62–80%), 92% (95% CI: 84–97%) for lung lobe, 88% (95% CI: 81–93%) for patients with history of exposure, and 91% (95% CI: 85–96%) for patients with all categories of symptoms. Seventy-six percent (95% CI: 67–83%) had age distribution across four age groups, while the pooled prevalence was higher in the male with 54% (95% CI: 50–57%) and 46% (95% CI: 43–50%) in the female. Conclusions: The sensitivity of RT-PCR was higher than chest CT, and disease prevalence appears relatively higher in the elderly and males than children and females, respectively.

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The Pulmonary Sequalae in Discharged Patients With COVID-19:A Short-term Observational Study

10.21203/rs.3.rs-21985/v2 ◽

2020 ◽

Author(s):

Dehan Liu ◽

Wanshu Zhang ◽

Feng Pan ◽

Lin Li ◽

Lian Yang ◽

...

Keyword(s):

Chest Ct ◽

Ct Scans ◽

Optimal Time ◽

Imaging Features ◽

Short Term ◽

Lung Lesions ◽

Cumulative Percentage ◽

Time Points ◽

Time Point

Abstract Background: A cluster of patients with coronavirus disease 2019 (COVID-19) pneumonia were discharged from hospitals in Wuhan, China. We aimed to determine the cumulative percentage of complete radiological resolution at each time point, to explore the relevant affecting factors, and to describe the chest CT findings at different time points after hospital discharge.Methods: Patients with COVID-19 pneumonia confirmed by RT-PCR who were discharged consecutively from the hospital between 5 February 2020 and 10 March 2020 and who underwent serial chest CT scans on schedule were enrolled. The radiological characteristics of all patients were collected and analysed. The total CT score was the sum of non-GGO involvement determined at discharge. Afterwards, all patients underwent chest CT scans during the 1st, 2nd, and 3rd weeks after discharge. Imaging features and distributions were analysed across different time points.Results: A total of 149 patients who completed all CT scans were evaluated; there were 67 (45.0%) men and 82 (55.0%) women, with a median age of 43 years old (IQR 36-56). The cumulative percentage of complete radiological resolution was 8.1% (12 patients), 41.6% (62), 50.3% (75), and 53% (79) at discharge and during the 1st, 2nd, and 3rd weeks after discharge, respectively. Patients ≤44 years old showed a significantly higher cumulative percentage of complete radiological resolution than patients >44 years old at the 3-week follow-up. The predominant patterns of abnormalities observed at discharge were ground-glass opacity (GGO) (65 [43.6%]), fibrous stripe (45 [30.2%]), and thickening of the adjacent pleura (16 [10.7%]). Lung lesions showed obvious resolution from 2 to 3 weeks after discharge, especially in terms of GGO and fibrous stripe. “Tinted” sign and bronchovascular bundle distortion as two special features were discovered during the evolution.Conclusion: Lung lesions in COVID-19 pneumonia patients can be absorbed completely during short-term follow-up with no sequelae. Three weeks after discharge might be the optimal time point for early radiological estimation.

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A false alarm of COVID-19 pneumonia in lung cancer: a case report of anti-PD-1 related pneumonitis and literature review

10.21203/rs.3.rs-41095/v1 ◽

2020 ◽

Author(s):

Ying Dai ◽

Sha Liu ◽

Zhiyan Zhao ◽

...

Keyword(s):

Lung Cancer ◽

Clinical Symptoms ◽

Close Contact ◽

Ct Imaging ◽

Chest Ct ◽

Radiographic Feature ◽

Rt Pcr ◽

Lung Lobe ◽

History Of ◽

Novel Coronavirus

Abstract Background: The fatal toxicity of anti-PD-1/PD-L1 agents is pneumonitis. The diagnosis consists of the history of immunotherapy, clinical symptoms and presentation of computed tomography (CT) imaging. The typical CT findings include ground-glass opacities. Based on the similar radiographic feature with 2019 Novel Coronavirus (COVID-19) pneumonia, clinicians are cautious to evaluate diagnosis especially in COVID-19 epidemic areas. Case presentation: Herein we report a 67-year-old male patient with advanced non-small cell lung cancer developed pneumonitis post Sintilimab injection. The dyspnea appeared at the 15th day of close contact with his son who returned from Wuhan, but not accompanied with fever. The chest CT indicated peripherally subpleural lattice opacities at the inferior right lung lobe and bilateral thoracic infusion. The real-time reverse-transcription polymerase-chain-reaction (RT-PCR) from double swab samples within 72 hours remained negative. The patient was thereafter treated with prednisolone and antibiotics for over two weeks. Thereafter the chest CT demonstrated the former lesion almost absorbed, in line with prominently falling CRP level. The anti-PD-1 related pneumonitis with bacterial infection was diagnosed finally based on the clinical evidence and good response to the prednisolone and antibiotics. Conclusion: Both ani-PD-1 related pneumonitis and COVID-19 pneumonia harbor the common clinical symptom and the varied features of CT imaging. Differential diagnosis was based on the epidemiological and immunotherapy histories, RT-PCR tests. The response to glucocorticoid can indirectly help the diagnosis.

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