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Comparación de los hallazgos en la tomografía computarizada de pacientes adultos y pediátricos con COVID-19
Institution:1. Drexel University College of Medicine, Philadelphia, Pennsylvania, USA;2. Mayo Clinic Alix School of Medicine, Scottsdale, Arizona, USA;3. USF College of Engineering, Tampa, Florida, USA;4. UCLA Department of Head and Neck Surgery, Los Angeles, California, USA;5. Duke University, Department of Biology, Durham, North Carolina, USA;6. Johns Hopkins University, Baltimore, Maryland, USA;7. USF College of Arts & Sciences, Tampa, Florida, USA;8. Ohio State Medical School, Columbus, Ohio, USA;9. University of California, San Francisco, California, USA
Abstract:ObjectiveInitial COVID-19 reports described a variety of clinical presentations, but lower respiratory abnormalities are most common and chest CT findings differ between adult and pediatric patients. We aim to summarize early CT findings to inform healthcare providers on the frequency of COVID-19 manifestations specific to adult or pediatric patients, and to determine if the sensitivity of CT justifies its use in these populations.MethodsPubMed was searched for the presence of the words “CT, imaging, COVID-19” in the title or abstract, and 17 large-scale PubMed and/or Scopus studies and case reports published between January 1, 2020 and April 15, 2020 were selected for data synthesis.ResultsInitial CT scans identified ground-glass opacities and bilateral abnormalities as more frequent in adults (74%, n = 698, and 89%, n = 378, respectively) than children (60%, n = 25, and 37%, n = 46). At 14+ days, CT scans evidenced varied degrees of improvement in adults but no resolution until at least 26 days after the onset of flu-like symptoms. In pediatric patients, a third (n = 9) showed additional small nodular GGOs limited to a single lobe 3-5 days after an initial CT scan.ConclusiónEarly adult CT findings suggest the limited use of CT as a supplemental tool in diagnosing COVID-19 in symptomatic adult patients, with a particular focus on identifying right and left lower lobe abnormalities, GGOs, and interlobular septal thickening. Early pediatric CT findings suggest against the use of CT if RT-PCR is available given its significantly lower sensitivity in this population and radiation exposure.
Keywords:COVID-19  SARS-CoV-2  Chest CT  Pediatrics  Imaging
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