The effectiveness of chest radiography in the diagnosis of pediatric COVID-19

Sinem Oral Cebeci 1 * , Hasret Ayyildiz Civan 2, Figen Palabıyık 3, İlyas Tolga Erkum 4, Nevin Hatipoğlu 5, Sami Hatipoğlu 4
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1 Department of Pediatric Emergency, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
2 Department of Pediatric Gastroenterology, Hepatology and Nutrition, Istanbul Bakirkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey
3 Department of Pediatric Radiology, Istanbul Bakirkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey
4 Department of Pediatrics, Istanbul Bakirkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey
5 Department of Pediatric Infections, Istanbul Bakirkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey
* Corresponding Author
J CLIN MED KAZ, Volume 18, Issue 2, pp. 20-24. https://doi.org/10.23950/jcmk/9718
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ABSTRACT

Objectives:
To determine the correlation between the PCR results and chest radiography findings of pediatric patients who were applied to pediatric emergency department with a suspicion of COVID-19 infection.

Methods:
A single-center retrospective single-blind study of patients who presented at the pediatric emergency department between 20.03.2020-15.04.2020. Patients with suspected COVID-19  infection were examined by nasopharyngeal and oropharyngeal swabs, PCR and posteroanterior (PA) chest radiographs. According to the PCR results, patients were divided into 2 groups as with (group 1) and without COVID 19 (group 2). All PA chest radiographs were evaluated by an experienced pediatric radiologist who did not know the PCR results.

Results:
167 patients were included in the study. Eighty (47.9%) of patients were female and 87 (52.1%) were male. The mean age was 8.6 ± 4.85 (1 month-16 years). The most common complaints were fever (%34.7) and cough (%54.5). 50 (32.9%) patients had a exposure history, 15 (9%) had a suspicious exposure history, and 102 (61.1%) had a history of exposure with a PCR proven COVID-19 patient. In patients with a contact to a COVID-19 patient, the most common source of infection was parents (65.7%). Out of 167 patients, 44 (26.3%) were PCR positive (group 1) and 123 (73.7%) were negative (group 2). 13 (29.5%) patients in group 1 and 14 (11.4%) patients in group 2 had findings on PA chest radiography. Among patients with signs on chest radiography (27 patients); eighteen (66.7%) patients had unilateral and 9 (33.3%) patients had bilateral lesion. In 15 (55.6%) of the cases, the finding was in single focus and in 12 (44.4%) there were multiple foci.
PA chest radiography findings were statistically significantly higher in group 1 compared to group 2 (p=0.008). There was no significant difference between the two groups in terms of bilateral lesion frequency and multi-focal presence (respectively, p=0,245, p=0,518). Unilateral lung findings were higher in group 1 compered to group 2 (p=0,023). The incidence of single focus was higher in the group 1 (20.4%) than group 2 (4.8%), (p=0,004).

Conclusion:
PA chest radiography which is widely used in all pediatric emergencies may help to diagnose COVID-19 patients with low dose radiation exposure. And this will help in rapid diagnosis and prevent unnecessary CT imaging in pediatric age group.

CITATION

Oral Cebeci S, Ayyildiz Civan H, Palabıyık F, Erkum İT, Hatipoğlu N, Hatipoğlu S. The effectiveness of chest radiography in the diagnosis of pediatric COVID-19. J CLIN MED KAZ. 2021;18(2):20-4. https://doi.org/10.23950/jcmk/9718

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