Role of chest computed tomography in the diagnosis of SARS-CoV-2 pneumonia in children

E. S. Korochkina, K. A. Khasanova
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Abstract

Background: First PCR-confirmed COVID-19 cases among Russian children were reported in early March 2020. Chest computed tomography (CT) is the most sensitive imaging modality in diagnosing early signs of viral lung damage. Limited data are available on clinical and laboratory features of COVID-19 in children and on their correlation with imaging findings. Studying COVID-19 features in children is crucial for modern medicine, which makes our research relevant. Objective: To determine the diagnostic efficacy and correlation between laboratory, clinical, and CT findings in children and adolescents with COVID-19. Materials and methods: From February 2020 to February 2021 372 patients with suspected COVID-19 were admitted to Morozov Children’s City Clinical Hospital (Moscow, Russian Federation). This retrospective study included 158 patients who presented with positive oropharyngeal and nasopharyngeal swab results, IgM and IgG test results, changes in complete blood count, blood biochemistry and coagulation test results, clinical symptoms, and suspected SARS-CoV-2 pneumonia based on chest CT findings. Results: Chest CT sensitivity and specificity for diagnosis of SARS-CoV-2 pneumonia were up to 98% and 85%, respectively. We considered that severe respiratory motion artifacts in young children under general anesthesia adversely affected the diagnostic efficacy. Sensitivity and specificity in this group were up to 89% and 71%, respectively. Conclusions: Viral pneumonia signs on chest CT scans were statistically significantly more frequent in children with cough, respiratory failure signs, lymphopenia, and increased D-dimer and C-reactive protein levels. One of these signs or a combination of them are an indication for chest CT in children with suspected SARS-CoV-2 pneumonia.
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胸部计算机断层扫描在儿童SARS-CoV-2肺炎诊断中的作用
背景:2020年3月初报告了俄罗斯儿童中首例聚合酶链反应确诊的COVID-19病例。胸部计算机断层扫描(CT)是诊断病毒性肺损伤早期体征最敏感的成像方式。关于儿童COVID-19的临床和实验室特征及其与影像学表现的相关性的数据有限。研究儿童COVID-19的特征对现代医学至关重要,因此我们的研究具有重要意义。目的:探讨儿童青少年新型冠状病毒肺炎(COVID-19)的实验室、临床和CT表现的诊断效果及相关性。材料与方法:2020年2月至2021年2月,俄罗斯莫罗佐夫儿童城市临床医院收治疑似COVID-19患者372例。本回顾性研究纳入了158例患者,这些患者均表现为口咽和鼻咽拭子结果阳性、IgM和IgG检测结果阳性、全血细胞计数、血液生化和凝血试验结果改变、临床症状,并根据胸部CT表现怀疑为SARS-CoV-2肺炎。结果:胸部CT诊断SARS-CoV-2肺炎的敏感性和特异性分别高达98%和85%。我们认为,在全麻下,幼儿严重的呼吸运动伪影对诊断效果有不利影响。该组的敏感性和特异性分别高达89%和71%。结论:在咳嗽、呼吸衰竭、淋巴细胞减少、d -二聚体和c反应蛋白水平升高的儿童中,胸部CT扫描的病毒性肺炎征象更频繁,具有统计学意义。这些症状之一或它们的组合是怀疑患有SARS-CoV-2肺炎的儿童进行胸部CT的指征。
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来源期刊
Innovatsionnaia meditsina Kubani
Innovatsionnaia meditsina Kubani Medicine-General Medicine
CiteScore
0.40
自引率
0.00%
发文量
34
审稿时长
6 weeks
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