Coronavirus disease 2019 (COVID-19) in children: a systematic review of imaging findings

Collaborators of the European Society of Paediatric Radiology Cardiothoracic Imaging Taskforce

Research output: Contribution to journalArticlepeer-review

33 Scopus citations


Background: COVID-19 is a novel coronavirus infection that can cause a severe respiratory illness and has been declared a pandemic by the World Health Organization (WHO). Because children appear to be less severely affected than adults, their imaging appearances have not been extensively reported. Objective: To systematically review available literature regarding imaging findings in paediatric cases of COVID-19. Materials and methods: We searched four databases (Medline, Embase, Cochrane, Google Scholar) for articles describing imaging findings in children with COVID-19. We included all modalities, age <18 years, and foreign language articles, using descriptive statistics to identify patterns and locations of imaging findings, and their association with outcomes. Results: Twenty-two articles were included, reporting chest imaging findings in 431 children, of whom 421 (97.7%) underwent CT. Criteria for imaging were lacking. At diagnosis, 143/421 (34.0%) had a normal CT. Abnormalities were more common in the lower lobes and were predominantly unilateral. The most common imaging pattern was ground-glass opacification (159/255, 62.4%). None of the studies described lymphadenopathy, while pleural effusions were rare (three cases). Improvement at follow-up CT imaging (3–15 days later) was seen in 29/100 (29%), remained normal in 25/100 (25%) and progressed in 9/100 (9%). Conclusion: CT chest findings in children with COVID-19 are frequently normal or mild. Lower lobes are predominantly affected by patchy ground-glass opacification. Appearances at follow-up remain normal or improve in the majority of children. Chest CT imaging adds little to the further management of the patient and should be reserved for severe cases or for identifying alternative diagnoses.

Original languageEnglish (US)
Pages (from-to)1217-1230
Number of pages14
JournalPediatric radiology
Issue number9
StatePublished - Aug 1 2020
Externally publishedYes


  • Adolescents
  • COVID-19
  • Children
  • Computed tomography
  • Coronavirus
  • Imaging
  • Radiology
  • Systematic review

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Radiology Nuclear Medicine and imaging


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