Pediatric Coronavirus Disease Pneumonia: What Radiologists N
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Pediatric patients with SARS tend to have a milder clinical course than adults with SARS, with up to 35% of pediatric patients with SARS found to have normal findings on chest radiographs. In pediatric SARS cases with a radiographic abnormality, the most frequently observed findings are patchy ground-glass opacities (GGOs) and areas of consolidation predominantly in lower lung zones, with multifocal involvement in up to one-third of affected patients. Cavitation, pleural effusion, and lymphadenopathy are generally absent.

CT is more sensitive than radiography for the detection of parenchymal abnormalities in patients with SARS and frequently shows parenchymal abnormalities when initial chest radiographs show normal findings. In pediatric patients, the most common CT findings during the acute period of SARS are unifocal or multifocal central or peripheral consolidations and GGOs. The extent of parenchymal injury visible on CT is often greater than that appreciated radiographically. Chu et al. evaluated the delayed manifestations of SARS in 47 pediatric patients 6 and 12 months after SARS-CoV diagnosis and found that the majority of patients (66%) had no imaging abnormalities at 6 months. The most common abnormalities observed at 6 months were persistent GGOs, air trapping, and small parenchymal scars. By 12 months after SARS-CoV diagnosis, GGOs had improved or resolved in all cases, but lower lobe–predominant subsegmental and subpleural air trapping and small parenchymal scars persisted in all cases.