DOI QR코드

DOI QR Code

Early CT Findings of Coronavirus Disease 2019 (COVID-19) in Asymptomatic Children: A Single-Center Experience

  • Lan Lan (Department of Radiology, Zhongnan Hospital of Wuhan University) ;
  • Dan Xu (Department of Radiology, Zhongnan Hospital of Wuhan University) ;
  • Chen Xia (Beijing Infervision Technology Co.) ;
  • Shaokang Wang (Beijing Infervision Technology Co.) ;
  • Minhua Yu (Department of Radiology, Zhongnan Hospital of Wuhan University) ;
  • Haibo Xu (Department of Radiology, Zhongnan Hospital of Wuhan University)
  • Received : 2020.03.05
  • Accepted : 2020.03.24
  • Published : 2020.07.01

Abstract

Objective: The current study reported a case series to illustrate the early computed tomography (CT) findings of coronavirus disease 2019 (COVID-19) in pediatric patients. Materials and Methods: All pediatric patients who were diagnosed with COVID-19 and who underwent CT scan in Zhongnan Hospital of Wuhan University from January 20, 2020 to February 28, 2020 were included in the current study. Data on clinical and CT features were collected and analyzed. Results: Four children were included in the current study. All of them were asymptomatic throughout the disease course (ranging from 7 days to 15 days), and none of them showed abnormalities in blood cell counts. Familial cluster was the main transmission pattern. Thin-section CT revealed abnormalities in three patients, and one patient did not present with any abnormal CT findings. Unilateral lung involvement was observed in two patients, and one patient showed bilateral lung involvement. In total, five small lesions were identified, including ground-glass opacity (n = 4) and consolidation (n = 1). All lesions had ill-defined margins with peripheral distribution and predilection of lower lobe. Conclusion: Small patches of ground-glass opacity with subpleural distribution and unilateral lung involvement were common findings on CT scans of pediatric patients in the early stage of the disease.

Keywords

Acknowledgement

This study was supported by the National Natural Science Foundation of China (Grants No.81771819), National key research and development plan of China (Grants No. 2017YFC0108803).

References

  1. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020;382:727-733 https://doi.org/10.1056/NEJMoa2001017
  2. World Health Organization. Coronavirus disease (COVID-2019) situation report [Accessed March 12, 2020]. Available at: https://www.who.int/emergencies/diseases/novel-%ADcoronavirus-%AD2019/situation-%ADreports/
  3. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020 Feb 7 [Epub]. http://doi.org/10.1001/jama.2020.1585
  4. 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. Lancet 2020;395:497-506 https://doi.org/10.1016/S0140-6736(20)30183-5
  5. Bai Y, Yao L, Wei T, Tian F, Jin DY, Chen L, et al. Presumed asymptomatic carrier transmission of COVID-19. JAMA 2020 Feb 21 [Epub]. http://doi.org/10.1001/jama.2020.2565
  6. Song F, Shi N, Shan F, Zhang Z, Shen J, Lu H, et al. Emerging 2019 novel coronavirus (2019-nCoV) pneumonia. Radiology 2020;295:210-217 https://doi.org/10.1148/radiol.2020200274
  7. Pan F, Ye T, Sun P, Gui S, Liang B, Li L, et al. Time course of lung changes on chest CT during recovery From 2019 novel coronavirus (COVID-19) pneumonia. Radiology 2020 Feb 13 [Epub]. http://doi.org/10.1148/radiol.2020200370
  8. Xie X, Zhong Z, Zhao W, Zheng C, Wang F, Liu J. Chest CT for Typical 2019-nCoV pneumonia: relationship to negative RTPCR testing. Radiology 2020 Feb 12 [Epub]. https://doi.org/10.1148/radiol.2020200343
  9. Bernheim A, Mei X, Huang M, Yang Y, Fayad ZA, Zhang N, et al. Chest CT findings in coronavirus disease-19 (COVID-19): relationship to duration of infection. Radiology 2020 Feb 20 [Epub]. https://doi.org/10.1148/radiol.2020200463
  10. Yoon SH, Lee KH, Kim JY, Lee YK, Ko H, Kim KH, et al. Chest radiographic and CT findings of the 2019 novel coronavirus disease (COVID-19): analysis of nine patients treated in Korea. Korean J Radiol 2020;21:494-500 https://doi.org/10.3348/kjr.2020.0132
  11. Wei J, Xu H, Xiong J, Shen Q, Fan B, Ye C, et al. 2019 novel coronavirus (COVID-19) pneumonia: serial computed tomography findings. Korean J Radiol 2020;21:501-504 https://doi.org/10.3348/kjr.2020.0112
  12. Li W, Cui H, Li K, Fang Y, Li S. Chest computed tomography in children with COVID-19 respiratory infection. Pediatr Radiol 2020 Mar 11 [Epub]. https://doi.org/10.1007/s00247-020-04656-7
  13. Xia W, Shao J, Guo Y, Peng X, Li Z, Hu D. Clinical and CT features in pediatric patients with COVID-19 infection: Different points from adults. Pediatr Pulmonol 2020 Mar 5 [Epub]. https://doi.org/10.1002/ppul.24718
  14. Liu W, Zhang Q, Chen J, Xiang R, Song H, Shu S, et al. Detection of covid-19 in children in early January 2020 in Wuhan, China. N Engl J Med 2020;382:1370-1371 https://doi.org/10.1056/NEJMc2003717
  15. 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. Nat Med 2020 Mar 13 [Epub]. https://doi.org/10.1038/s41591-020-0817-4
  16. China National Health Commission. Diagnosis and treatment of COVID-19 pneumonia in China (trial version 7) [Accessed March 4, 2020]. Available at: www.nhc.gov.cn/yzygj/s7652m/202003/a31191442e29474b98bfed5579d5af95.shtml
  17. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020 Feb 28 [Epub]. http://doi.org/10.1056/NEJMoa2002032
  18. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020;395:507-513 https://doi.org/10.1016/S0140-6736(20)30211-7
  19. Ai T, Yang Z, Hou H, Zhan C, Chen C, Lv W, et al. Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19) in China: a report of 1014 cases. Radiology 2020 Feb 26 [Epub]. https://doi.org/10.1148/radiol.2020200642
  20. H Li, H Xu. Guidelines for imaging diagnosis of COVID-19 in China (2020, version 1). YI XUE XIN ZHI 2020;30:22-34
  21. Shi H, Han X, Jiang N, Cao Y, Alwalid O, Gu J, et al. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infect Dis 2020;20:425-434 https://doi.org/10.1016/S1473-3099(20)30086-4
  22. 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 Feb 14 [Epub]. http://doi.org/10.1001/jama.2020.2131