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Clinical Features and Temporal Changes of RT-PCR and Chest CT in COVID-19 Pediatric Patients: A Diagnostic Strategy Study
26 Pages Posted: 16 Apr 2020
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Clinical Features and Temporal Changes of RT-PCR and Chest CT in COVID-19 Pediatric Patients: A Diagnostic Strategy Study
Clinical Features and Temporal Changes of RT-PCR and Chest CT in COVID-19 Pediatric Patients: A Diagnostic Strategy Study
Abstract
Background: To explore the clinical features and temporal changes of RT-PCR and CT in COVID-19 pediatric patients, and determine the optimum diagnostic strategy.
Methods: 114 COVID-19 pediatric inpatients were retrospectively reviewed. All patients had chest CT on admission and were identified as positive on pharyngeal swab nucleic acid test. Clinical features were analyzed, as well as the features of RT-PCR and chest CT. The temporal changes of RT-PCR and chest CT were evaluated.
Results: Fever (62, 54%) and cough (61, 54%) were the most common symptoms, while 20% of patients were asymptomatic. The most common imaging findings on CT of the chest were ground-glass opacities and consolidation. The bilateral lower lobes were the most common pattern of involvement, with 63 cases (55%) involving 1-2 lobes, and in 32 (28%) cases CT was normal. Through the whole duration of COVID-19 in children, the diagnostic positive rate of RT-PCR has been far higher than that of CT (All P ＜0·01). For RT-PCR follow-up, reliable negative results were obtained 7 days after the onset of symptoms. Changes in chest CT peaked at 11 to 15 days after the onset of symptoms and involved an average of 1·5 lung lobes.
Interpretations: RT-PCR is more reliable than CT in initial diagnosis of pediatric patients infected with COVID-19. On follow up, reliable RT-PCR results are not available until at least 7 days after initial symptoms. The optimum time to perform a chest CT examination is 11 to 15 days after the onset of symptoms, and follow-up may be performed if necessary.
Funding Statement: National Natural Science Foundation of China 81771801. Wuhan Children’s Hospital Foundation 2020FE002 HUST Innovation Project 2020.
Declaration of Interests: The authors of this manuscript declare that there is no conflict of interest.
Ethics Approval Statement: The local institutional review board approved this retrospective study, and informed consent was waived.
Keywords: Child; COVID-19; infection; clinical features; tomography
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