Recommendations issued for imaging use in pediatric COVID-19

(HealthDay)—In an international expert consensus statement, published online April 23 in Radiology: Cardiothoracic Imaging, recommendations are presented for chest imaging in pediatric COVID-19 patient management.

Alexandra M. Foust, D.O., from Boston Children's Hospital, and colleagues created a consensus statement addressing imaging manifestations of pediatric COVID-19 and offering recommendations for use of chest radiographs (CXR) and computed tomography (CT).

The researchers present imaging recommendations for pediatric patients in three clinical situations depending on COVID-19 severity and resource constraints. The potential risks of imaging, including COVID-19 exposure to radiology staff and radiation exposure, should be considered. Imaging is not recommended for most patients with mild clinical features of COVID-19; for those at risk for disease progression, imaging is recommended to serve as a baseline and assess alternative diagnoses. Chest CT is not recommended even for those at increased risk for progression but may be considered in cases of clinical progression or with inadequate clinical improvement. For pediatric patients with moderate-to-severe features of COVID-19, those in an environment without resource constraints should undergo CXR for initial evaluation. Chest CT may be considered if the outcome will impact clinical decision making. For patients in a resource-constrained environment, imaging may be used to evaluate for findings indicative of COVID-19. Sequential imaging is recommended on an as-clinically needed basis, similar to adult patients.

"As knowledge about the presentation and evolution of COVID-19 pneumonia in pediatric patients continues to grow, the information and recommendations provided by this document may undergo additional refinement," the authors write.

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