Document Type : original article
Authors
Pediatric Respiratory Disease Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Abstract
Background: There is a paucity of quantitative studies on COVID-19 in children, and with the rising trend of infection in children, there is a need for more information in the clinical and paraclinical domains to be shared.
Objectives: The present research was designed to investigate the clinical and paraclinical manifestations of children with COVID-19 referred to Dr. Masih Daneshvari Hospital from September 2021 to September 2022 to maintain intuition into assessment and effective management of COVID-19 infection in children.
Methods: In this cross-sectional study, 70 children (under 18 years old) with COVID-19 who met the study entry criteria were included. Demographic characteristics, including the age and gender of the patients, as well as the family history of COVID-19 exposure, were recorded for the patients. CT scan findings of the patients were documented according to a standard questionnaire. The study results were analyzed and examined using SPSS software to enhance the diagnosis.
Results: Among the 70 study subjects, 66 individuals (94.3%) tested positive for PCR-COVID, and four individuals tested negative for PCR-COVID. Only 38 cases (54.3%) reported common findings on CT scans. Fever, cough, and lethargy were the most common clinical findings in the study population.
Conclusions: The presence of GGO on CT scans in children with COVID-19 should be regarded as an important indicator of the disease worsening. Among the clinical symptoms of chills, dyspnea, and myalgia had significant correlations with CT findings—particularly when two or all three symptoms were present. This allows clinicians to predict pulmonary involvement with reasonable accuracy and may help in deciding when to avoid unnecessary CT scans.
Keywords
- Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The lancet. 2020 Feb 15;395(10223):497-506.
- Hui DS, Azhar EI, Madani TA, Ntoumi F, Kock R, Dar O, et al. The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health—The latest 2019 novel coronavirus outbreak in Wuhan, China. International journal of infectious diseases. 2020 Feb 1;91:264-6.
- Hobbs CV. Factors Associated with Positive SARS-CoV-2 Test Results in Outpatient Health Facilities and Emergency Departments Among Children and Adolescents Aged 18 Years—Mississippi, September–November 2020. MMWR. Morbidity and Mortality Weekly Report. 2020;69.
- Ludvigsson JF. Systematic review of COVID‐19 in children shows milder cases and a better prognosis than adults. Acta paediatrica. 2020 Jun;109(6):1088-95.
- Goss MB, Galván NT, Ruan W, Munoz FM, Brewer ED, O’Mahony CA, et al. The pediatric solid organ transplant experience with COVID‐19: an initial multi‐center, multi‐organ case series. Pediatric transplantation. 2021 May;25(3):e13868.
- Millen GC, Arnold R, Cazier JB, Curley H, Feltbower RG, Gamble A, et al. Severity of COVID-19 in children with cancer: report from the United Kingdom Paediatric Coronavirus Cancer Monitoring Project. British journal of cancer. 2021 Feb 16;124(4):754-9.
- Williams PC, Howard-Jones AR, Hsu P, Palasanthiran P, Gray PE, McMullan BJ, et al. SARS-CoV-2 in children: spectrum of disease, transmission and immunopathological underpinnings. Pathology. 2020 Dec 1;52(7):801-8.
- Wei M, Yuan J, Liu Y, Fu T, Yu X, Zhang ZJ. Novel coronavirus infection in hospitalized infants under 1 year of age in China. Jama. 2020 Apr 7;323(13):1313-4.
- Cao Q, Chen YC, Chen CL, Chiu CH. SARS-CoV-2 infection in children: Transmission dynamics and clinical characteristics. Journal of the Formosan Medical Association. 2020 Mar;119(3):670.
- Allen H, Vusirikala A, Flannagan J, Twohig KA, Zaidi A, Chudasama D, et al. Household transmission of COVID-19 cases associated with SARS-CoV-2 delta variant (B. 1.617. 2): national case-control study. The Lancet Regional Health–Europe. 2022 Jan 1;12.
- Sheikh A, McMenamin J, Taylor B, Robertson C. SARS-CoV-2 Delta VOC in Scotland: demographics, risk of hospital admission, and vaccine effectiveness. The Lancet. 2021 Jun 26;397(10293):2461-2.
- Wu F, Zhao S, Yu B, Chen YM, Wang W, Song ZG, et al. A new coronavirus associated with human respiratory disease in China. Nature. 2020 Mar;579(7798):265-9.
- Neeland MR, Bannister S, Clifford V, Dohle K, Mulholland K, Sutton P, et al. Innate cell profiles during the acute and convalescent phase of SARS-CoV-2 infection in children. Nature communications. 2021 Feb 17;12(1):1084.
- Korakas E, Ikonomidis I, Kousathana F, Balampanis K, Kountouri A, Raptis A, et al. Obesity and COVID-19: immune and metabolic derangement as a possible link to adverse clinical outcomes. American Journal of Physiology-Endocrinology and Metabolism. 2020 Jul 1;319(1):E105-9.
- Migliorini F, Torsiello E, Spiezia F, Oliva F, Tingart M, Maffulli N. Association between HLA genotypes and COVID-19 susceptibility, severity and progression: a comprehensive review of the literature. European Journal of Medical Research. 2021 Dec;26:1-9.
- Langton DJ, Bourke SC, Lie BA, Reiff G, Natu S, Darlay R, et al. The influence of HLA genotype on the severity of COVID‐19 infection. Hla. 2021 Jul;98(1):14-22.
- Irfan O, Muttalib F, Tang K, Jiang L, Lassi ZS, Bhutta Z. Clinical characteristics, treatment and outcomes of paediatric COVID-19: a systematic review and meta-analysis. Archives of disease in childhood. 2021 May 1;106(5):440-8.
- Mehrabi S, Safaei M, Ghandi Y, Bahrami M. Chest CT Features in Pediatric Patients with COVID‐19 Infection: A Brief Review Article. International Journal of Pediatrics. 2021 Apr 1;9(4):13421-7.
- National Clinical Evidence Taskforce. Living Guidelines: National COVID‐19 Clinical Evidence Taskforce 2021. Available from: WWW.livingevidence.org.au/living-guidelines/covid-19 .
- Azarbakhsh H, Jokari K, Moftakhar L, Ghojogh MG, Karimyan A, Salmanzadeh S, et al. Epidemiological characteristics of patients with COVID-19 in Southwest of Iran from February 19 to June 20, 2020. Medical journal of the Islamic Republic of Iran. 2021;35:116.
- Steinberger S, Lin B, Bernheim A, Chung M, Gao Y, Xie Z, et al. CT features of coronavirus disease (COVID-19) in 30 pediatric patients. American Journal of Roentgenology. 2020 May 1:1303-11.
- Rahimzadeh G, Ekrami Noghabi M, Kadkhodaei Elyaderani F, Navaeifar MR, Enayati AA, et al. COVID-19 infection in Iranian children: a case series of 9 patients. Journal of Pediatrics Review. 2020 Apr 10;8(2):139-44.
- Armin S, Mirkarimi M, Pourmoghaddas Z, Tariverdi M, Jafrasteh A, Marhamati N, et al. Iranian pediatric COVID‐19 epidemiology and clinical characteristics. Canadian Journal of Infectious Diseases and Medical Microbiology. 2021;2021(1):4914371.
- Mahmoudi S, Mehdizadeh M, Shervin Badv R, Navaeian A, Pourakbari B, Rostamyan M, et al. The coronavirus disease 2019 (COVID-19) in children: a study in an Iranian Children’s Referral Hospital. Infection and drug resistance. 2020 Jul 31:2649-55.
- Kim C, Kim JY, Lee EJ, Kang YM, Song KH, Kim ES, et al. Clinical findings, viral load, and outcomes of COVID-19: Comparison of patients with negative and positive initial chest computed tomography. Plos one. 2022 Mar 3;17(3):e0264711.
- Liu H, Liu F, Li J, Zhang T, Wang D, Lan W. Clinical and CT imaging features of the COVID-19 pneumonia: Focus on pregnant women and children. Journal of infection. 2020 May 1;80(5):e7-13.
- Xu Y, Li X, Zhu B, Liang H, Fang C, Gong Y, et al. Characteristics of pediatric SARS-CoV-2 infection and potential evidence for persistent fecal viral shedding. Nature medicine. 2020 Apr;26(4):502-5.
- Ghodsi A, Bijari M, Alamdaran SA, Saberi A, Mahmoudabadi E, Balali MR, et al. Chest computed tomography findings of COVID-19 in children younger than 1 year: a systematic review. World Journal of Pediatrics. 2021 Jun;17(3):234-41.
)