Pulmonary Imaging Findings in Coronavirus Disease 2019 (COVID-19): A Series of 140 Latin American Children

Abstract Background:The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 virus), which resulted in the worldwide COVID-19 pandemic of 2020, has particularly affected Latin America. Objective:The purpose of the study was to analyze the imaging findings of pulmonary COVID-19 in a large pediatric series.Materials and methods:Children with confirmed SARS-CoV-2 infection confirmed by either quantitative reverse transcription-polymerase chain reaction from nasopharyngeal swabs or presence of circulating IgM and/or IgG antibodies and who underwent chest radiograph (CXR) and/or computed tomography (CT) were included in this retrospective multicenter study. Three pediatric radiologists independently reviewed CXRs and CTs to identify the presence, localization, distribution and extension of pulmonary lesions. Results:One hundred and forty children (71 female; median age 6.2 years; interquartile range 1.6-12.1 years) were included in the study. Peribronchial thickening (93%), ground glass opacities (79%) and vascular engorgement (63%) were the most frequent findings on 131 CXRs. Ground glass opacities (91%), vascular engorgement (84%) and peribronchial thickening (72%) were the most frequent findings on 32 CTs. Peribronchial thickening (100%), ground-glass opacities (90%) and pulmonary vascular engorgement (74%) were common CXR findings in asymptomatic patients (n=20). Consolidation and ground-glass opacity were significantly higher in patients who needed ICU admission or expired, in contrast with patients with a good outcome (48% and 91%, vs 24% and 70% p<0.05, respectively).Conclusion:Asymptomatic children and those with mild symptoms of COVID-19 showed mainly peribronchial thickening, ground-glass opacities and pulmonary vascular engorgement on CXRs. Ground glass opacity and consolidation, were more common in patients who required ICU admission or died.