# Comparison of radiologic findings between SARS-CoV-2 and other respiratory tract viruses in critically ill children during the COVID-19 pandemic

## TL;DR

This study compares chest X-ray and CT findings in critically ill children with SARS-CoV-2 and other respiratory viruses to help distinguish between them.

## Contribution

The study identifies differences in radiologic features between SARS-CoV-2 and other respiratory viruses in critically ill children.

## Key findings

- Chest X-rays were more normal in SARS-CoV-2-positive patients compared to others.
- Rhinovirus cases showed more unilateral consolidation on chest X-rays.
- RVP-positive patients had more bilateral peribronchial changes on CT scans.

## Abstract

This study was planned because the radiological distinction of COVID-19 and respiratory viral panel (RVP)-positive cases is necessary to prioritize intensive care needs and ensure non-COVID-19 cases are not overlooked. With that purpose, the objective of this study was to compare radiologic findings between SARS-CoV-2 and other respiratory airway viruses in critically ill children with suspected COVID-19 disease.

This study was conducted as a multicenter, retrospective, observational, and cohort study in 24 pediatric intensive care units between March 1 and May 31, 2020. SARS-CoV-2- or RVP polymerase chain reaction (PCR)-positive patients’ chest X-ray and thoracic computed tomography (CT) findings were evaluated blindly by pediatric radiologists.

We enrolled 225 patients in the study, 81 of whom tested positive for Coronovirus disease-19 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The median age of all patients was 24 (7–96) months, while it was 96 (17–156) months for COVID-19-positive patients and 17 (6–48) months for positive for other RVP factor (p < 0.001). Chest X-rays were more frequently evaluated as normal in patients with SARS-CoV-2 positive results (p = 0.020). Unilateral segmental or lobar consolidation was observed more frequently on chest X-rays in rhinovirus cases than in other groups (p = 0.038). CT imaging findings of bilateral peribronchial thickening and/or peribronchial opacity were more frequently observed in RVP-positive patients (p = 0.046).

Chest X-ray and CT findings in COVID-19 patients are not specific and can be seen in other respiratory virus infections.