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. 2023 Aug 17:11:1172111.
doi: 10.3389/fped.2023.1172111. eCollection 2023.

Clinical and radiological characteristics of pediatric COVID-19 before and after the Omicron outbreak: a multi-center study

Bin Lin #  1 , Xiaopei Xu #  1 , Zhujing Shen  1 , Peiyu Huang  1 , Yuantong Gao  2 , Jun Liu  3 , Zongyu Xie  4 , Tongtong Zhao  5 , Junli Xia  6 , Jian Lv  7 , Dawei Ren  8 , Hanpeng Zheng  9 , Xiangming Wang  10 , Minghua Hu  11 , Guixiang Ruan  12 , Minming Zhang  1
Affiliations

Clinical and radiological characteristics of pediatric COVID-19 before and after the Omicron outbreak: a multi-center study

Bin Lin et al. Front Pediatr. .

Abstract

Introduction: The emergence of the Omicron variant has seen changes in the clinical and radiological presentations of COVID-19 in pediatric patients. We sought to compare these features between patients infected in the early phase of the pandemic and those during the Omicron outbreak.

Methods: A retrospective study was conducted on 68 pediatric COVID-19 patients, of which 31 were infected with the original SARS-CoV-2 strain (original group) and 37 with the Omicron variant (Omicron group). Clinical symptoms and chest CT scans were examined to assess clinical characteristics, and the extent and severity of lung involvement.

Results: Pediatric COVID-19 patients predominantly had normal or mild chest CT findings. The Omicron group demonstrated a significantly reduced CT severity score than the original group. Ground-glass opacities were the prevalent radiological findings in both sets. The Omicron group presented with fewer symptoms, had milder clinical manifestations, and recovered faster than the original group.

Discussion: The clinical and radiological characteristics of pediatric COVID-19 patients have evolved with the advent of the Omicron variant. For children displaying severe symptoms warranting CT examinations, it is crucial to weigh the implications of ionizing radiation and employ customized scanning protocols and protective measures. This research offers insights into the shifting disease spectrum, aiding in the effective diagnosis and treatment of pediatric COVID-19 patients.

Keywords: COVID-19; CT; children; pediatric; radiation protection.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
17-year-old boy infected with the original SARS-CoV-2. Initial unenhanced chest CT scans show consolidation with air bronchogram (arrow) in the posterior basal segment of lower right lung and consolidation with ground glass opacities in the posterior basal segment of lower left lobe. These CT findings were assigned CT severity score of 3.
Figure 2
Figure 2
15-year-old boy infected with the original SARS-CoV-2. Initial unenhanced chest CT scans show multiple subpleural consolidations (black thin arrow) accompanied by ground glass opacities (white short arow) in lingual segment of left upper lobe and posterior basal segment of lower left lobe. Streaky opacities (white long arrow) are shown in right middle lobe and lingual segment of left upper lobe. CT findings were assigned CT severity score of 10.
Figure 3
Figure 3
17-year-old boy infected with the original SARS-CoV-2. Initial unenhanced chest CT scans show ground glass opacity and consolidation with septal thickening (crazy paving pattern) in right lower lobe (white short arrow). Multiple ground glass opacities with septal thickening (crazy paving pattern) are seen in the lower right lobe (white long arrow). CT findings were assigned CT severity score of 5.
Figure 4
Figure 4
17-year-old girl infected with the Omicron variant of SARS-CoV-2. Unenhanced chest CT scans show pulmonary nodule with peripheral halo sign in the lower lobe of the right lung. CT findings were assigned CT severity score of 1.
Figure 5
Figure 5
22-month-old boy infected with the Omicron variant of SARS-CoV-2. Unenhanced chest CT scans show consolidation in the apical segment of the right upper lobe. CT findings were as-signed CT severity score of 1.
Figure 6
Figure 6
8-year-old boy infected with the Omicron variant of SARS-CoV-2. Unenhanced chest CT scans show ground glass opacity in the right middle lobe. CT findings were assigned CT severity score of 1.
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