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Chest CT Abnormalities and Their Association with Disease Severity and Outcome in Hospitalized Children with COVID-19: A Cross-Sectional Study | ||
| World Journal of Peri & Neonatology | ||
| Article 7, Volume 8, Issue 1, May 2026 | ||
| Document Type: Original Article | ||
| Authors | ||
| Bozorgmehr Samanian1; Mehran Karimi* 1; Amir Pasha Amel Shahbaz2; Farimah Shamsi3; Reza Nafisi Moghadam2 | ||
| 1Children Growth Disorder Research Center, Comprehensive Research Institute for Maternal and Child Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran | ||
| 2Department of Radiology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran | ||
| 3Center for Healthcare Data Modeling, Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran | ||
| Abstract | ||
| Background: Although COVID-19 is generally milder in children, a subset develops severe pulmonary involvement requiring hospitalization. Evidence linking chest CT abnormalities to clinical outcomes in hospitalized children is limited. We evaluated CT findings and their association with clinical presentation, disease severity, oxygen saturation, and short-term outcome. Methods: This cross‑sectional study included 82 RT‑PCR‑confirmed COVID‑19 patients aged 1 month to 18 years admitted to Shahid Sadoughi Hospital, Yazd, Iran. Clinical data and CT images (interpreted by a radiologist) were extracted from medical records. Associations were tested with chi‑square/Fisher’s exact tests. Results: CT abnormalities were present in 63 patients (76.8%). Ground‑glass opacity was most common (50%), followed by consolidation (29.3%), atelectasis (14.6%), and pleural effusion (8.5%). Severe/critical disease was significantly more frequent in the abnormal‑CT group (76.2% vs. 36.8%, p=0.006). Oxygen saturation <94% was strongly associated with CT abnormalities (95.8% vs. 71.8%, p=0.02). All six deaths occurred among patients with abnormal CT (p=0.03). No significant associations were found for fever, cough, respiratory distress, or age group. Age group (1 month–1 year, 1–5 years, 5–13 years, 13–18 years) was not significantly associated with CT findings. Conclusion: In this cohort of hospitalized children with clinically indicated CT imaging, chest CT abnormalities were common and were significantly associated with severe disease, hypoxemia, and mortality. Individual symptoms were not significantly associated with CT findings. Because CT was performed only when clinically indicated, the observed prevalence of abnormalities likely overestimates that in the broader hospitalized population; the results do not support routine screening. Limitations include the absence of post‑discharge follow‑up and potential selection bias | ||
| Keywords | ||
| COVID-19; Child; Computed Tomography; Severity of Illness Index; Diagnostic Imaging | ||
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