Pediatrik COVID-19 Vakalarında Akciğer Bilgisayarlı Tomografisi Ne Kadar Değerli?

Amaç: Çocuk COVID-19 olgularının akciğer tomografi, laboratuar ve klinik özelliklerini karşılaştırarak, akciğer BT’sinin tanı ve tedavideki önemini araştırmayı amaçladık. Materyal ve Metot: Mart 2020- Nisan 2020 tarihleri arasında çocuk kliniğimizde COVID-19 şüphesi ile izlenen 45 çocuk hastanın klinik ve radyolojik bulguları , hastanemizin elektronik kayıt sisteminden elde edilerek değerlendirildi. Bulgular: Olguların 24’ü kız, 21’i erkek ve ortanca yaş 177 aydı. Otuz iki hastanın RT-PCRsonucu pozitif, 13 hastanın negatifti. En sık görülen semptom öksürük (%87) idi. Hastaların 33’ünde temas öyküsü vardı. Olguların 30’unda COVID-19 u düşündüren göğüs BT bulguları vardı. RT-PCR sonuçları ile akciğer BT bulguları arasında anlamlı ilişki yoktu. Akciğer BT derecelendirmesi ile CRP arasında arasında anlamlı ilişki bulundu (p< 0.01). Sonuç: Çalışmamızda çocuk olgularda göğüs BT’sinin, tanı koymada ve tedavi planlanmasında herhangi bir üstünlüğü olmadığı görülmüştür. Bu nedenle çocuklardan göğüs BT isterken radyasyonun olası hasarları düşünülerek klinik gereklilik göz önünde bulundurulmalıdır.
Anahtar Kelimeler:

COVID-19, Çocuk, Akciğer BT

How Valuable is ChestComputed Tomography in Pediatric Patients with Coronavirus Disease 2019?

Objective: We aimed to investigate the importance of chest CT in diagnosis and treatment of pediatric patients with COVID-19 by comparing chest CT, laboratory, and clinical features. Materials and Methods: The clinical and image findings of 45 children with suspected COVID-19 , addmited to our pediatric clinic between March and April ,2020 were obtained from hospital electronic records. Results: The median age of children was 177 months, while 24 of the patients were female and 21 were male. RT-PCR results of 32 children were positive and of 13 were negative. The most common symptom was cough (87%). Thirty-three of the patients had a history of contact with an infected person. Chest CT images of the 30 cases suggested COVID-19. There was no significant relationship between RT-PCR results and chest CT findings. A significant correlation was found between chest CT severity and CRP (p <0.01). Conclusion: In our study, it was observed that chest CT does not have any advantage in diagnosis and treatment planning in pediatric cases. Therefore, considering the radiation exposure associated with CT scan, physicians should beware of clinical symptoms in children.

___

  • World Health Organization. Novel coronavirus China2020. https://www.who.int/csr/don/12-january-2020-novel-coronaviruschina/en/. Accessed 15 Feb 2020.
  • International committee on taxonomy viruses naming the 2019coronavirus2020. https://talk.ictvonline.org/. Accessed 15 Feb 2020.
  • World Health Organization. Novel coronavirus (2019-nCoV) situation report – 222020. https://www.who.int/docs/default-source/ coronaviruse/situation-reports. /20200211-sitrep-22-ncov.pdf?sfvrsn= fb6d49b1_2. Accessed 15 Feb 2020.
  • World Health Organization. Novel coronavirus (2019-nCoV) situation report – 1172020. https://www.who.int/docs/default–source/coronaviruse/situation–reports. Accessed 16 May 2020.
  • Yasuhara J, Kuno T, Takagi H, Sumitomo N. Clinical characteristics of COVID-19 in children: A systematic review. Pediatr Pulmonol. 2020;55:2565–2575.
  • Tagarro A, Epalza C, Santos M, et al. Screening and severity of Coronavirus Disease 2019 (COVID-19) in Children in Madrid, Spain. JAMA Pediatr. 2020. doi:10.1001/jamapediatrics.2020.1346
  • Korean Society of Infectious D, Korean Society of Pediatric Infectious D, Korean Society of E, et al. Report on the Epidemiological Features of Coronavirus Disease 2019 (COVID-19) Outbreak in the Republic of Korea from January 19 to March 2, 2020. J Korean Med Sci. 2020;35: e112.
  • Dong Y, Mo X, Hu Y, et al. Epidemiology of COVID-19 among children in China. Pediatrics. 2020. doi:10.1542/peds.2020–0702
  • Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382:1708–1720.
  • British Society of Thoracic Imaging. Thoracic Imaging in COVID 19 Infection Guidance for the Reporting Radiologist Version 2.2020 https://www.bsti.org.uk/standards-clinical-guidelines/clinical-guidelines/bsti-covid-19-guidance-for-the-reporting-radiologist/. Accessed 20 May 2020.
  • Centers for Disease Control and Prevention (CDC).Coronavirus Disease 2019 in Children COVID-19 Response Team. MMWR Morb Mortal Wkly Rep. 2020;69(14):422 .
  • Ma H, Hu J, Tian J, et al. A single-center, retrospective study of COVID-19 features in children: a descriptive investigation. BMC Med. 2020;18(1):123. doi:10.1186/s12916-020-01596-9
  • Xia W, Shao J, Guo Y, Peng X, Li Z, Hu D. Clinical and CT features in pediatric patients with COVID-19 infection: Different points from adults. Pediatr Pulmonol. 2020;55(5):1169-1174. doi:10.1002/ppul.24718
  • Li Y, Cao J, Zhang X, et al. Chest CT imaging characteristics of COVID-19 pneumonia in preschool children: a retrospective study. BMC Pediatr. 2020;20(1):227. doi:10.1186/s12887-020-02140-7
  • Lu Y, Wen H, Rong D, Zhou Z, Liu H. Clinical characteristics and radiological features of children infected with the 2019 novel coronavirus. Clin Radiol. 2020;75(7):520-525. doi:10.1016/j.crad.2020.04.010
  • Zheng F, Liao C, Fan QH et al. Clinical characteristics of children with coronavirus disease 2019 in Hubei, China. Curr Med Sci. 2020;24:1-6. doi:10.1007/s11596-020-2172-6
  • Jonker FA, Boele van Hensbroek M. Anaemia, iron deficiency and susceptibility to infections. J Infect. 2014;69 Supp l1:S23-7.
  • Merkus PJ, Klein WM. Value of Chest CT as COVID 19 screening tool in children. Eur Respir J. 2020;2001241. doi:10.1183/13993003.01241-2020
  • Xie X, Zhong Z, Zhao W, Zheng C, Wang F, Liu J. Chest CT for typical 2019-nCoV pneumonia: relationship to negative RT-PCR testing. Radiology. 2020;296:41-45. doi:10.1148/radiol.2020200343
  • Fang Y, Zhang H, Xie J, et al. Sensitivity of Chest CT for COVID-19: Comparison to RT-PCR. Radiology. 2020;296:115-197. doi:10.1148/radiol.2020200432
  • Chen Z, Fu J, Shu Q, et al. Diagnosis and treatment recommendation for pediatric coronavirus disease-19. Zhejiang Da Xue Xue Bao Yi Xue Ban. 2020;49(1):1–8.
  • DuanY, Zhu Y, Tang L, et al. CT features of novel coronavirus pneumonia (COVID-19) in children. EurRadiol. 2020;14:1-7. doi:10.1007/s00330-020-06860-3
  • Li HJ, Liu SY, Xu HB, Cheng JL. Guideline for medical imaging in auxiliary diagnosis of coronavirus disease 2019. Chin J Med Imaging Technol. 2020;36:1–11.
  • Zhou Y, Yang GD, Feng K, et al. Clinical features and chest CT findings of coronavirus disease 2019 in infants and young children. Zhongguo Dang Dai Er Ke Za Zhi. 2020;22(3):215-220. doi:10.1016/j.inf.2020.03.007
  • Liua H , Liub F, Li J, Zhanga T, Wanga D, Lanb W. Clinical and CT Imaging Features of the COVID-19 Pneumonia: Focus on Pregnant Women and Children. The Journal of Infection. 2020;80(5):7-13. doi:10.1016/j.jinf.2020.03.007
  • Feng K, Yun YX, Wang XF, et al. Analysis of CT features of 15 children with 2019 novel coronavirus infection. Zhonghua Er Ke Za Zhi. 2020;58(0):E007. doi:10.3760/cma.j.issn.0578-1310.2020.0007
  • Koo HJ, Lim S, Choe J, Choi SH, Sung H, Do KH. Radiographic and CT Features of Viral Pneumonia. Radiographics. 2018;38(3):719–39.
  • Wang D, Ju XL, Xie F, et al. Clinical analysis of 31 cases of 2019 novel coronavirus infection in children from six provinces (autonomous region) of northern China. Chin J Pediatr. 2020;58(4):269-274. doi:10.3760/cma.j.cn112140-20200225-00138
  • Li W, Cui H, Li K, Fang Y, Li S. Chest computed tomography in children with COVID-19 respiratory infection. Pediatr Radiol. 2020;50(6):796-799. doi:10.1007/s00247-020-04656-7
Online Türk Sağlık Bilimleri Dergisi-Cover
  • ISSN: 2459-1467
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2016
  • Yayıncı: Oğuz KARABAY
Sayıdaki Diğer Makaleler

Poliklinikten Non-Reaktif Non-Stress Test Ön Tanısıyla Doğum Ünitesine Yönlendirilen Term Gebelerde Sezaryen Oranlarının ve Perinatal Sonuçların Değerlendirilmesi

İsa Şükrü ÖZ

Dev Omfalosel: 23 Hasta; Üç Farklı Yaklaşım

Mustafa Alper AKAY

Pediatrik COVID-19 Vakalarında Akciğer Bilgisayarlı Tomografisi Ne Kadar Değerli?

Aysun BOGA, Neşe ERGÜL, Kemal PİŞMİŞOĞLU, Şirin GÜVEN, Halit CAM, Nurettin YİYİT, Umut ERGÜL, Taha Yusuf KUZAN, Murat CİHAN

İntravenöz Katater Uygulamasında Kullanılan Kelebek Desenli Tespit Malzemesinin Çocukların Emosyonel ve Fizyolojik Göstergelerine Etkisi

Ezgi Gamze BURUNSUZ, SELMİN KÖSE

Nanoteknoloji ve Nanobiyomalzemeler: Ağız Kanserini Yönetme Yollarını Yeniden Tanımlama

Akanksha JUNEJA, Amina SULTAN

COVID-19 Pozitif Hastaya Hemşirelik Bakımı Veren Bir Hemşirenin Deneyimleri: Olgu Sunumu

Canan BİRİMOĞLU OKUYAN, Elifnur GÜNEŞ, Esra YEŞİLYURT

Endometrial Hiperplazi ve Karsinomunda Nükleus Boyutunun Karşılaştırmalı Morfometrik Analizi

Ayşe Nur Uğur KILINÇ, Sıdıka FINDIK, Pembe OLTULU

Beyin Ölümü Tanısı Alan Hastaların Retrospektif Analizi

Onur PALABIYIK

Evde Sağlık Hizmetlerinde İnformal Bakım Verenlerin Bilgi ve Beceri Düzeyinin Belirlenmesi

Özden GÜDÜK, Özlem GÜDÜK, Yaşar SERTBAŞ

Pediatrik Hastalarda Postoperatif Dönemde Ağrı ve Deliryumu Ayırt Etmede FLACC ve OPS Ölçeklerinin Karşılaştırılması

Kevser PEKER, Seydi Ali PEKER