INTRODUCTION
Since 2013, COVID-19 has posed a challenge to the medical community
worldwide. Since March of 2020, it began as a pandemic and is now in
transition to its endemic phase . Despite all efforts and the
introduction of vaccines, it still considered a significant public
health concern because it has affected more than 760 million people and
caused 6.8 million fatalities worldwide . In addition, infants and
adolescents continue to account for 21% of the infected population .
Given the supporting evidence for brief and long-term multisystemic
complications of COVID-19 , early detection and treatment of this
disease in pediatrics and related fields will continue to be essential.
Thoracic diagnostic imaging has been an instrument for evaluation of
patients with COVID-19 in context of respiratory disease. A growing
number of adult and pediatric investigations have focused on describing
findings on chest radiography (CXR) and computed tomography (CT) scans.
COVID-19 has been examined using CXR as a diagnostic tool. Current
American College of Radiology guidelines, mention this imaging technique
as first line for the diagnosis of pediatric patients with COVID-19 who
have mild symptoms and comorbidities, or moderate to severe symptoms .
Although medical literature characterizes CT scan for this disease
mostly normal, when there is a finding the most common ones were glass
ground and parabronchial opacities as well as consolidations. This
imaging modality has been widely utilized for adult patients; however,
it must be considered that the majority of pediatric patients were less
likely to have positive chest CT results . In addition, CT is utilized
less frequently than CXR due to the elevated risks associated with
sedation (when necessary) and the long-term carcinogenic risk for
pediatric patients posed by exposure to ionizing radiation .
A group of experts issued a consensus statement on the imaging
manifestations of COVID-19 in the pediatric population in 2020,
categorizing findings as typical, indeterminate, atypical, and negative
. In addition, other pediatric and radiology specialists have attempted
to address other general imaging findings in CXR , such as
characteristics focusing on zonal predominance , their relationship with
specific complications, such as multisystem inflammatory syndrome in
children (MIS-C) and even the use of ultrasound (US) and artificial
intelligence as alternative tools. Even though there is substantial
evidence from studies in the adult population, there is less evidence
from studies and smaller sample sizes in the pediatric population.
However, it is essential to recognize that the reported low concordance
of radiographic findings in patients with lower respiratory disease is a
potential limitation of radiology. This limitation may impact the
accuracy and dependability of radiologists ‘interpretations of COVID-19
in pediatric patients. This limitation must be addressed and
comprehended in order to ensure the correct application and
interpretation of radiological findings in clinical practice.
This study´s primary objective is to characterize the radiological
findings in pediatric in-patients with confirmed SARS-CoV2 infection in
Colombia between March 2020 and November 2021, with a focus on their
relationship to clinical presentation, treatment, and outcomes. In
addition, as a secondary objective, we intend to assess the concordance
of these radiological findings among radiologists in order to ascertain
their true impact on clinical practice.