Clinical and imaging features of pediatric COVID-19
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ABSTRACT:
SUBMITTER: Zhang Y
PROVIDER: S-EPMC7556551 | biostudies-literature | 2020 Jan
REPOSITORIES: biostudies-literature
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Project description:BackgroundCOVID-19 is an extremely severe infectious disease. However, few studies have focused on the epidemiological and clinical characteristics of pediatric COVID-19. This study conducted a retrospective review of the epidemiological and clinical features of COVID-19 in children.MethodsA retrospective study was conducted on children with a definite diagnosis of COVID-19 in mainland China using the web crawler technique to collect anonymous COVID-19 updates published by local health authorities.ResultsThree hundred forty-one children aged 4 days to 14 years with a median age of 7 years were included. Sixty-six percent of pediatric patients were infected via family members with COVID-19. The median incubation period was 9 days (interquartile range, 6 to 13). Asymptomatic cases accounted for 5.9%, of which 30% had abnormal chest radiologic findings. A majority of pediatric COVID-19 cases showed mild to moderate clinical features, and only a few developed severe or critical diseases (0.6% and 0.3%, respectively). Fever (77.9%) and cough (32.4%) were the predominant presenting symptoms of pediatric COVID-19. The pediatric patients had fewer underlying diseases and complications than adults. The treatment modalities for pediatric COVID-19 patients were not as complex as those of adult COVID-19 patients. The overall prognosis of pediatric COVID-19 was benign with a decent recovery. The median time from onset to cure was 16 days (interquartile range, 13 to 21).ConclusionsCompared to adults, COVID-19 in children has distinct features of epidemiology and clinical manifestations. The findings from this study might help to guide the development of measures to prevent and treat this ongoing global pandemic.Trial registrationChinese Clinical Trial Registry ( chictr.org.cn ) identifier: ChiCTR2000030464.
| S-EPMC7408975 | biostudies-literature
Project description:AbstractPediatric cases of coronavirus disease 2019 (COVID-19) have been reported. This meta-analysis was aimed at describing the clinical, laboratory, and imaging characteristics of children with COVID-19 based on published data of pediatric COVID-19 cases.Search of PubMed, Embase, Web of Sciences, Science Direct, and Google Scholar for articles published until December 14, 2020, that described the clinical, laboratory, and imaging features of children with COVID-19. Data were extracted independently by 2 authors. Random-effects meta-analysis models were used to report pooled results.Clinical data from 2874 children with COVID-19 from 37 articles were finally included for quantitative analyses. Fever (48.5%, 95% CI: 41.4%-55.6%) and cough (40.6%, 95% CI: 33.9%-47.5%) were the most common symptoms; asymptomatic infection and severe cases, respectively, accounted for 27.7% (95% CI: 19.7%-36.4%) patients and 1.1% of the 1933 patients included. Laboratory tests showed 5.5% (95% CI: 2.8%-8.9%) of the patients had lymphopenia. The pooled prevalence of leukopenia was 7.3% (95% CI: 3.4%-12.2%), and the C-reactive protein level was high in 14.0% (95% CI: 6.8%-22.8%). Chest computed tomography showed unilateral and bilateral lesions, and ground-glass opacity in 29.4% (95% CI: 24.8%-34.3%) and 24.7% (95% CI: 18.2%-31.6%), and 32.9% (95% CI: 25.3%-40.9%), respectively, and normal in approximately 36.0% (95% CI: 27.7%-44.7%).We found that children with COVID-19 had relatively mild disease, with quite a lot of asymptomatic infections and low rate of severe illness. Data from more regions are needed to determine the prevention and treatment strategies for children with COVID-19.
| S-EPMC8052054 | biostudies-literature
Project description:BACKGROUND:Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 has spread around the world, and reports of children with COVID-19 are increasing. OBJECTIVES:To assess clinical profiles of pediatric COVID-19. STUDY DESIGN:A retrospective analysis was undertaken using clinical data of sixteen children (11 months-14 years) diagnosed with COVID-19 between January 1, 2020 and March 17, 2020 at Xiangyang Central Hospital, Hubei province, China. RESULTS:All children had positive epidemiologic histories, 12 (12/16, 75 %) involving family units. The illnesses were either mild (5/16, 31.3 %) or ordinary (11/16, 68.8 %), presenting as follows: asymptomatic (8/16, 50 %), fever and/or cough (8/16, 50 %). Four asymptomatic patients (4/16, 25 %) in ordinary cases had chest computed tomography (CT) abnormalities. Leukocyte counts were normal in 14 cases(88 %), but 2 patients (12.5 %) had leukopenia, and 1 (6.3 %) was lymphopenic. There were 11 patients with chest CT abnormalities, some nodular, others small patchy and others ground-glass opacities. In asymptomatic children, the median time to SRAS-CoV-2 nucleic acid test(NAT) positivity once exposed to a family member with confirmed infection was 15.5 days (range, 10-26 days). The median time to first NAT-negative conversion was 5.5 days (range, 1-23 days). CONCLUSIONS:COVID-19 in children of Xiangyang city is often family acquired and not serious, with favorable outcomes. Asymptomatic children can be diagnosed as pneumonia because of chest CT abnormalities. It is essential to actively screen this segment of the population.
| S-EPMC7195294 | biostudies-literature
Project description:The new coronavirus disease 2019 (COVID-19) pandemic has challenged many healthcare systems around the world. While most of the current understanding of the clinical features of COVID-19 is derived from Chinese studies, there is a relative paucity of reports from the remaining global health community. In this study, we analyze the clinical and radiologic factors that correlate with mortality odds in COVID-19 positive patients from a tertiary care center in Tehran, Iran. A retrospective cohort study of 90 patients with reverse transcriptase-polymerase chain reaction (RT-PCR) positive COVID-19 infection was conducted, analyzing demographics, co-morbidities, presenting symptoms, vital signs, laboratory values, chest radiograph findings, and chest CT features based on mortality. Chest radiograph was assessed using the Radiographic Assessment of Lung Edema (RALE) scoring system. Chest CTs were assessed according to the opacification pattern, distribution, and standardized severity score. Initial and follow-up Chest CTs were compared if available. Multiple logistic regression was used to generate a prediction model for mortality. The 90 patients included 59 men and 31 women (59.4 ± 16.6 years), including 21 deceased and 69 surviving patients. Among clinical features, advanced age (p = 0.02), low oxygenation saturation (p<0.001), leukocytosis (p = 0.02), low lymphocyte fraction (p = 0.03), and low platelet count (p = 0.048) were associated with increased mortality. High RALE score on initial chest radiograph (p = 0.002), presence of pleural effusions on initial CT chest (p = 0.005), development of pleural effusions on follow-up CT chest (p = 0.04), and worsening lung severity score on follow-up CT Chest (p = 0.03) were associated with mortality. A two-factor logistic model using patient age and oxygen saturation was created, which demonstrates 89% accuracy and area under the ROC curve of 0.86 (p<0.0001). Specific demographic, clinical, and imaging features are associated with increased mortality in COVID-19 infections. Attention to these features can help optimize patient management.
| S-EPMC7514030 | biostudies-literature
Project description:In this article we will review the imaging features of coronavirus disease 2019 (COVID-19) across multiple modalities, including radiography, CT, MRI, PET/CT, and US. Given that COVID-19 primarily affects the lung parenchyma by causing pneumonia, our directive is to focus on thoracic findings associated with COVID-19. We aim to enhance radiologists' understanding of this disease to help guide diagnosis and management. Supplemental material is available for this article. © RSNA, 2020.
| S-EPMC7325394 | biostudies-literature
Project description:Coronavirus disease 2019 (COVID-19) is a novel and highly contagious disease caused by Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Older adults and patients with comorbidities and immunosuppressive conditions may experience severe signs and symptoms that can lead to death. This case series assesses the clinical course, imaging features, and outcomes for 12 patients with COVID-19 and a history of kidney transplantation. Patients were evaluated for symptoms, laboratory data, imaging findings, and outcomes from February 2020 to April 2020. Fever, cough, and dyspnea were the most common clinical symptoms, noted in 75% (nine/12), 75% (nine/12), and 41.7% (five/12) of the patients, respectively. Most of the patients had a normal white blood cell count, while 33.3% (four/12) had leukopenia and 8.3% (one/12) had leukocytosis. A combination of consolidation and ground glass opacity was the most predominant (75%) pattern of lung involvement on computed tomography (CT). Eight patients died of severe COVID-19 pneumonia and acute respiratory distress syndrome and four were discharged. All recovered cases had a unilateral peripheral pattern of involvement limited to only one zone on initial chest CT. It seems that CT imaging has an important role in predicting COVID-19 outcomes for solid organ transplant recipients. Future studies with long-term follow up and more cases are needed to elucidate COVID-19 diagnosis, outcome, and management strategies for these patients.
| S-EPMC7200360 | biostudies-literature
Project description: Not available
| S-EPMC8687826 | biostudies-literature
Project description:Rationale and objectivesThis study aims to reveal the imaging features of Coronavirus Disease 2019 (COVID-19) in children.Materials and methodsSixty-nine chest radiographs and 37 chest CT examinations of 74 children (36 male; median (interquartile range) age:11 (6.25-15) years, 38 female; median (interquartile range) age: 12 (5.75-16) years) with positive real-time reverse transcription-polymerase chain reaction results between March 10 and May 31, 2020, were evaluated in this retrospective study. Differences in 0-<6, 6-<12, and 12-18 years of age groups were assessed with the Fisher's exact test or Kruskal-Wallis tests.ResultsRight-sided (3/69, 4.3%) or bilateral (3/69, 4.3%) ground-glass opacities without significant difference in age groups were depicted as radiographic findings related to COVID-19 in children. Opacities were either single (7/37, 18.9%) or bilateral (7/37, 18.9%) around the distal third of the bronchovascular bundle on CT. There was no significant difference in the median size of the largest opacities, total numbers of opacities and involved lobes, and the distance of the closest opacity to the pleura among age groups (p > 0.05). The rate of ground-glass opacities with or without consolidation (17/37, 45.94%) was higher than consolidation alone (6/37, 16.2%). Feeding vessel sign (16/37, 43.2%), halo sign (9/37, 24.3%), pleural thickening (6/37, 16.2%), interlobular interstitial thickening (5/37, 13.5%), and lymphadenopathy (3/37, 8.1%) were other imaging findings.ConclusionUnilateral or bilateral distributed ground-glass opacities often associated with feeding vessel sign, halo sign, and pleural thickening on chest CT without significant differences between age groups were findings of COVID-19 in children.
| S-EPMC7534757 | biostudies-literature
Project description:IntroductionAn epidemic of Coronavirus Disease 2019 (COVID-19) began in December 2019 in China leading to a Public Health Emergency of International Concern (PHEIC). Clinical, laboratory, and imaging features have been partially characterized in some observational studies. No systematic reviews on COVID-19 have been published to date.MethodsWe performed a systematic literature review with meta-analysis, using three databases to assess clinical, laboratory, imaging features, and outcomes of COVID-19 confirmed cases. Observational studies and also case reports, were included, and analyzed separately. We performed a random-effects model meta-analysis to calculate pooled prevalences and 95% confidence intervals (95%CI).Results660 articles were retrieved for the time frame (1/1/2020-2/23/2020). After screening, 27 articles were selected for full-text assessment, 19 being finally included for qualitative and quantitative analyses. Additionally, 39 case report articles were included and analyzed separately. For 656 patients, fever (88.7%, 95%CI 84.5-92.9%), cough (57.6%, 95%CI 40.8-74.4%) and dyspnea (45.6%, 95%CI 10.9-80.4%) were the most prevalent manifestations. Among the patients, 20.3% (95%CI 10.0-30.6%) required intensive care unit (ICU), 32.8% presented with acute respiratory distress syndrome (ARDS) (95%CI 13.7-51.8), 6.2% (95%CI 3.1-9.3) with shock. Some 13.9% (95%CI 6.2-21.5%) of hospitalized patients had fatal outcomes (case fatality rate, CFR).ConclusionCOVID-19 brings a huge burden to healthcare facilities, especially in patients with comorbidities. ICU was required for approximately 20% of polymorbid, COVID-19 infected patients and hospitalization was associated with a CFR of >13%. As this virus spreads globally, countries need to urgently prepare human resources, infrastructure and facilities to treat severe COVID-19.
| S-EPMC7102608 | biostudies-literature
Project description:Analysis of plasma from adult and pediatric COVID-19 patients via untargeted and targeted proteomics reveals activation in complement and coagulation pathways as common elements in both populations
2023-03-06 | PXD040437 | Pride