Chest CT Abnormalities and Disease Severity in Hospitalized Children with COVID 19: A Retrospective Cohort Study

Document Type : Original Article

Authors

1 Children Growth Disorder Research Center, Comprehensive Research Institute for Maternal and Child Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

2 Mother and Newborn Health Research Center, Comprehensive Research Institute for Maternal and Child Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

3 Department of Radiology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

4 Center 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 retrospective cohort study included 82 RT‑PCR‑confirmed COVID‑19 patients aged 1 month 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 hospitalized children with clinically indicated chest CT, pulmonary abnormalities were frequent and associated with severe disease and hypoxemia, while symptoms alone did not predict radiologic involvement. All deaths occurred in the abnormal‑CT group. Routine CT screening is not supported, and findings require prospective validation.

Keywords

References

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Journal of Integrated Maternal and Pediatric Care
Volume 8, Issue 1
May 2026
Pages 50-58

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History

  • Receive Date: 25 May 2026
  • Accept Date: 25 May 2026

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