Department of Pediatric Intensive Care, Ankara City Hospital, Ankara, Turkiye.
Department of Pediatric Intensive Care, Ankara University School of Medicine, Ankara, Turkiye.
Turk J Med Sci. 2024 Mar 11;54(3):517-528. doi: 10.55730/1300-0144.5818. eCollection 2024.
BACKGROUND/AIM: This study was planned because the radiological distinction of COVID-19 and respiratory viral panel (RVP)-positive cases is necessary to prioritize intensive care needs and ensure non-COVID-19 cases are not overlooked. With that purpose, the objective of this study was to compare radiologic findings between SARS-CoV-2 and other respiratory airway viruses in critically ill children with suspected COVID-19 disease.
This study was conducted as a multicenter, retrospective, observational, and cohort study in 24 pediatric intensive care units between March 1 and May 31, 2020. SARS-CoV-2- or RVP polymerase chain reaction (PCR)-positive patients' chest X-ray and thoracic computed tomography (CT) findings were evaluated blindly by pediatric radiologists.
We enrolled 225 patients in the study, 81 of whom tested positive for Coronovirus disease-19 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The median age of all patients was 24 (7-96) months, while it was 96 (17-156) months for COVID-19-positive patients and 17 (6-48) months for positive for other RVP factor (p < 0.001). Chest X-rays were more frequently evaluated as normal in patients with SARS-CoV-2 positive results (p = 0.020). Unilateral segmental or lobar consolidation was observed more frequently on chest X-rays in rhinovirus cases than in other groups (p = 0.038). CT imaging findings of bilateral peribronchial thickening and/or peribronchial opacity were more frequently observed in RVP-positive patients (p = 0.046).
Chest X-ray and CT findings in COVID-19 patients are not specific and can be seen in other respiratory virus infections.
背景/目的：由于需要对 COVID-19 和呼吸道病毒组合检测（RVP）阳性病例进行影像学区分，以确定重症监护需求的优先级，并确保不会忽视非 COVID-19 病例，因此计划开展本项研究。本研究旨在比较疑似 COVID-19 疾病的危重症患儿中 SARS-CoV-2 与其他呼吸道病毒的影像学表现。
本研究是一项多中心、回顾性、观察性、队列研究，于 2020 年 3 月 1 日至 5 月 31 日在 24 个儿科重症监护病房进行。由儿科放射科医生对 SARS-CoV-2 或 RVP 聚合酶链反应（PCR）阳性患者的胸部 X 线和胸部计算机断层扫描（CT）结果进行盲法评估。
本研究共纳入 225 例患者，其中 81 例经检测为严重急性呼吸综合征冠状病毒-2（SARS-CoV-2）所致 2019 年冠状病毒病（COVID-19）阳性。所有患者的中位年龄为 24（7-96）个月，COVID-19 阳性患者的中位年龄为 96（17-156）个月，其他 RVP 阳性因素患者的中位年龄为 17（6-48）个月（p＜0.001）。SARS-CoV-2 阳性患者的胸部 X 线更常表现为正常（p=0.020）。与其他组相比，鼻病毒病例的胸部 X 线更常表现为单侧节段性或肺叶性实变（p=0.038）。RVP 阳性患者的 CT 影像学表现更常为双侧细支气管壁增厚和/或细支气管周围混浊（p=0.046）。
COVID-19 患者的胸部 X 线和 CT 表现无特异性，也可见于其他呼吸道病毒感染。
