Thorax Computed Tomography Imaging and Chest X-Rays Results in Children with Different Clinical-Stages of COVID-19

Objective: Coronavirus disease-2019 (COVID-19) has milder clinical fea-tures in children, but information on the association between thoracic imaging and clinical severity of COVID-19 is limited. Material and Methods: Between March 26th and June 30th, 2020, 982 patients with suspected or confirmed COVID-19, 428 of whom had chest X-rays, were included in the study. Demographic and clinical features, chest X-ray and thoracic computed tomography (CT) imaging results, and clinical severity of the disease were analyzed retrospectively. Results: Laboratory-proven COVID-19 was detected in 116 (27.1%) pa-tients; 42 (36.3%) had asymptomatic, 60 (51.7%) had mild, 12 (10.3%) had moderate, and two (1.7%) had severe disease. Chest X-rays were abnormal in 12.1% (14/116) of the patients with confirmed COVID-19. Main pathologic findings on chest X-ray were peribranchial thickening (10/14, 71.4%) and ground-glass opacity (GGO) (4/14, 28.6%) in patients with confirmed COVID-19. Thorax CT imaging was performed in 182 (42.5%) patients, 38 (32.7%) had confirmed COVID-19, 39.5% (15/38) of whom had abnormal imaging. Posterior (n= 7), peripheral (n= 7), and both lobe (n= 5) involvement were more prominent. Consolidated GGO (7/38, 18.4%) and bronchial wall thickening (7/38, 18.4%) were the main pathologic CT imaging patterns. Thorax CT images were abnor-mal in 20% (5/25) of the patients with asymptomatic/mild disease, and in 76.9% (10/13) of the patients with moderate/severe disease (& chi;2= 11.5, Phi= 0.552; p= 0.001). Conclusion: Chest X-ray and thorax CT imaging were mainly normal in patients with asymptomatic/mild COVID-19 disease. In contrast, thorax CT imaging was abnormal in patients with moderate/severe COVID-19, and CT imaging scores correlated with COVID-19 clinical severity. How-ever, since COVID-19 disease is milder in children, applications involving high amounts of radiation such as thoracic CT imaging should only be applied to selected patients.