Pediatric Pulmonology

Symptomatic COVID-19 can present in a wide variety of ways. Fever, sore throat, rhinorrhea, cough, and shortness of breath are the most common presenting symptoms in the pediatric population. Most symptomatic cases are mild, especially compared to adults, and present with either upper respiratory tract symptoms consistent with croup or lower respiratory tract symptoms consistent with pneumonia. However, some children may progress to respiratory failure and acute respiratory distress syndrome (ARDS), and some develop multi-inflammatory syndrome (MIS-C)

Imaging is not recommended in mild cases of COVID-19. In patients with moderate-severe symptoms a chest x-ray may be helpful. Common findings may include bilateral, patchy, opacities in the peripheral lower lung fields.

Research

Pediatric Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): Clinical Presentation, Infectivity, and Immune Responses

Yonker LM et al. J Pediatr 2020.

This study indicated that children may be a potential source of contagion in the SARS-CoV-2 pandemic despite having milder disease or a lack of symptoms.

Reviews

Practical Guide for Pediatric Pulmonologists on Imaging Management of Pediatric Patients with COVID-19

Foust AM et al. Pediatr Pulmonol 2020.