Ghoneim Mahitab, Eid Riham, Hamdy Nashwa, Shokry Doaa, Salem Mohammed A, El-Morsy Ahmed, Elmokadem Ali H
Mansoura University, Egypt.
Pol J Radiol. 2022 Mar 2;87:e126-e140. doi: 10.5114/pjr.2022.114505. eCollection 2022.
The outbreak of a new coronavirus is still spreading worldwide, affecting children and adults. However, COVID-19 in children shows distinctive characteristics in clinical and radiological presentation. We aimed to assess the diagnostic performance of chest CT and clarify the clinicoradiological CT features of COVID-19 among children with COVID-19.
Adhering to PRISMA-DTA guidelines, we searched databases (PubMed, Google Scholar, and Web of Science) to identify relevant articles. The search keywords were: "Chest CT" AND "COVID-19" OR "coronavirus" OR "SARS-COV-2" AND "Children" OR "Pediatric". Published reports providing clinical and imaging findings of paediatric COVID-19 were included.
Twenty-eight studies were included, with 987 patients. Most of the patients were symptomatic (76.9%; 95% CI: 69.2-84.7%), with fever being the most frequent manifestation (64%; 95% CI: 58.0-71.2%). Only 2.3% of the cases were critical, and mortality was reported in one case. The proportion of COVID-19 detected by chest CT among children is relatively high (658/987), with ground-glass opacity (GGO) being the most prevalent feature (52.5%; 95% CI: 40.5-64.7%). The pooled sensitivity of chest CT in all patients was 67%; however, it was different between symptomatic and asymptomatic patients (71% and 33%, respectively). The pooled specificity was (67%), which was calculated after considering the symptomatic PCR-positive patients as the gold standard.
Chest CT showed moderate pooled sensitivity and specificity among symptomatic children with COVID-19 and low sensitivity among asymptomatic children. This means that CT is not to be used as a screening tool or for confirmation of the diagnosis in children and should be reserved for specific clinical situations.
新型冠状病毒的爆发仍在全球范围内蔓延，影响着儿童和成人。然而，儿童新冠肺炎在临床和影像学表现上具有独特特征。我们旨在评估胸部CT的诊断性能，并阐明新冠肺炎儿童患者的临床放射学CT特征。
遵循PRISMA-DTA指南，我们检索了数据库（PubMed、谷歌学术和科学网）以识别相关文章。检索关键词为：“胸部CT” 及 “新冠肺炎” 或 “冠状病毒” 或 “SARS-CoV-2” 以及 “儿童” 或 “儿科”。纳入提供儿科新冠肺炎临床和影像学表现的已发表报告。
纳入28项研究，共987例患者。大多数患者有症状（76.9%；95%置信区间：69.2 - 84.7%），发热是最常见的表现（64%；95%置信区间：58.0 - 71.2%）。仅2.3%的病例为重症，有1例报告死亡。儿童中通过胸部CT检测出的新冠肺炎比例相对较高（658/987），磨玻璃影（GGO）是最常见的特征（52.5%；95%置信区间：40.5 - 64.7%）。所有患者中胸部CT的合并敏感度为67%；然而，有症状和无症状患者之间存在差异（分别为71%和33%）。合并特异度为（67%），这是在将有症状PCR阳性患者视为金标准后计算得出的。
胸部CT在有症状的新冠肺炎儿童中显示出中等的合并敏感度和特异度，而在无症状儿童中敏感度较低。这意味着CT不应作为儿童的筛查工具或用于确诊，应仅用于特定临床情况。
