Chest CT Abnormalities and Disease Severity in Hospitalized Children with COVID 19: A Retrospective Cohort Study

Bozorgmehr  Samanian; Mehran  Karimi; Amir Pasha Amel  Shahbaz; Farimah  Shamsi; Reza Nafisi  Moghadam

doi:10.18502/wjpn.v8i1.21584

Bozorgmehr Samanian Children Growth Disorder Research Center, Comprehensive Research Institute for Maternal and Child Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Mehran Karimi Mother and Newborn Health Research Center, Comprehensive Research Institute for Maternal and Child Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Amir Pasha Amel Shahbaz Department of Radiology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Farimah Shamsi Center for Healthcare Data Modeling, Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Reza Nafisi Moghadam Department of Radiology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

DOI: https://doi.org/10.18502/wjpn.v8i1.21584

Keywords: COVID-19; Child; Computed Tomography; Severity of Illness Index; Diagnostic Imaging

Abstract

Background: Although COVID-19 is generally milder in children, asubset develops severe pulmonary involvement requiring hospitalization.Evidence linking chest CT abnormalities to clinical outcomes inhospitalized children is limited. We evaluated CT findings and theirassociation with clinical presentation, disease severity, oxygen saturation,and short-term outcome.

Methods:Hospital, Yazd, Iran. Clinical data and CT images (interpreted by aradiologist) were extracted from medical records. Associations were tested.Results: CT abnormalities were presentopacity was most common (50%), followed by consolidation (29.3%),atelectasis (14.6%), and pleural effusion (8.5%). Severe/critical disease was0.006). Oxygen saturation <94% was strongly associated with CTabnormalities (95.8% vs. 71.8%, P = 0.02). All six deaths occurred amongpatients with abnormal CT (P = 0.03). No significant associations were foundfor fever, cough, respiratory distress, or age group. Age group (1 month 1year, 1 5 years, 5 13 years, 13 18 years) was not significantly associatedwith CT findings.Conclusion: In hospitalized children with clinically indicated chest CT,pulmonary abnormalities were frequent and associated with severedisease and hypoxemia, while symptoms alone did not predict radiologicinvolvement. All deaths occurred in the abnormal-CT group. Routine CTscreening is not supported, and findings require prospective validation