Pediatric Lung Imaging Features of Covid-19: A Systematic Review and Meta-Analysis.

Nino, Gustavo; Zember, Jonathan; Sanchez-Jacob, Ramon; Gutierrez, Maria J; Sharma, Karun; Linguraru, Marius George

RATIONALE Pediatric COVID-19 studies have been mostly restricted to case reports and small case series, which have prevented the identification of specific pediatric lung disease patterns in COVID-19. The overarching goal of this systematic review and meta-analysis is to provide the first comprehensive summary of the findings of published studies thus far describing COVID-19 lung imaging data in the pediatric population. METHODS A systematic literature search of PubMed was performed to identify studies assessing lung-imaging features of COVID-19 pediatric patients (0-18 years). A single-arm meta-analysis was conducted to obtain the pooled prevalence and 95% confidence interval (95% CI). RESULTS A total of 29 articles (n=1026 children) based on chest CT images were included. The main results of this comprehensive analysis are as follows: (1) Over a third of pediatric patients with COVID-19 (35.7%, 95% CI: 27.5%-44%) had normal chest CT scans and only 27.7% (95% CI: 19.9%-35.6%) had bilateral lesions; (2) the most typical pediatric chest CT findings of COVID-19 were ground-glass opacities (GGO) (37.2%, 95% CI: 29.3%-45%) and the presence of consolidations or pneumonic infiltrates (22.3%, 95% CI: 17.8%-26.9%); (3) the lung imaging findings in children with COVID-19 were overall less frequent and less severe than in adult patients; and (4) typical lung imaging features of viral respiratory infections in the pediatric population such as increased perihilar markings and hyperinflation were not reported in children with COVID-19. CONCLUSION Chest CT manifestations in children with COVID-19 could potentially be used for early identification and prompt intervention in the pediatric population. This article is protected by copyright. All rights reserved.