Chest Radiographic Findings in Hospitalized Children with COVID-19: A Cross-Sectional Study in Yazd, Iran

Authors

  • Ahmad Shajari Department of Medical Sciences, Ali-Ebne-Abitaleb School of Medicine, Islamic Azad University, Yazd, Iran
  • Saeideh Daya Department of Medical Sciences, Ali-Ebne-Abitaleb School of Medicine, Islamic Azad University, Yazd, Iran
  • Mehran Karimi Children Growth Disorder 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
  • Elahe Akbarian Children Growth Disorder Research Center, Comprehensive Research Institute for Maternal and Child Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

DOI:

https://doi.org/10.18502/wjpn.v8i2.22106

Keywords:

COVID-19; Chest X-ray; Children; Radiology; Prognosis

Abstract

Background: Chest X-ray (CXR) patterns in pediatric COVID-19 are not well described. We aimed to characterize CXR findings in hospitalized children and to examine their associations with clinical and laboratory features.

Methods: This cross-sectional study included all children (<18 years) with PCR-confirmed or clinically/radiologically diagnosed COVID-19 admitted to Shahid Sadoughi Hospital, Yazd, Iran, between February 2020 and March 2021. Admission CXRs were interpreted by a single radiologist and scored (0–18) across six lung zones. Clinical, laboratory, and outcome data were retrieved from a registry. Associations were tested with Chi-square, Mann–Whitney U, or Kruskal–Wallis tests.

Results: Among 108 children (61.1% male; mean age 5.7 ± 4.8 years), 68 (62.9%) had an abnormal CXR. The most frequent patterns were ground-glass opacity (86.8%), peribronchial thickening (54.4%), and consolidation (45.6%). Lesions were predominantly peripheral (50.0%), bilateral (82.4%), and involved the right lower zone (52.2%). Pleural effusion (14.7%) strongly predicted mortality (risk difference 32.5%, P<0.001). Consolidation was more common with shortness of breath (68.0% vs. 20.0%, P = 0.001) but less common in respiratory distress (36.7% vs. 64.7%, P = 0.045). Higher CXR severity scores were associated with underlying comorbidities, hypoxia, PICU admission, and critical illness in previously healthy children (P = 0.002).

Conclusion: Bilateral peripheral ground-glass opacity and peribronchial thickening are common in pediatric COVID-19. Consolidation, pleural effusion, and high radiographic scores correlate with severe disease and poor outcomes, supporting CXR as a useful adjunct for risk stratification in moderate-to-severe cases, rather than universal screening.

Published

2026-07-21

Issue

Volume (8) issue (2)

Section

Articles