SARS-CoV-2 paediatric chest X-ray findings during the Omicron variant wave

Abstract

Background: The coronavirus disease 2019 (COVID-19) is caused by a novel beta coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]). The Omicron variant was first identified in November 2021 in multiple countries, including South Africa. The authors aimed to assess chest radiographs to ascertain whether unique radiographic manifestations were related to this variant.
Objectives: The primary objective was to identify key chest X-ray findings in the South African paediatric population testing positive for SARS-CoV-2 during the Omicron era. The secondary objective was to help differentiate between Omicron chest X-ray findings and published findings regarding all preceding variants.
Method: A retrospective cohort review was conducted at three main healthcare academic centres, in which 94 paediatric chest X-rays were assessed by three consultant radiologists to identify key imaging findings.
Results: Ground-glass opacities were more common among infants (45.4%) than children (20%) and adolescents (20%; p = 0.001). Peribronchial thickening was high in all age groups: 97.7% in infants, 87.5% in children and 70% in adolescents (p = 0.019). Consolidation was seen in 28.6% of infants, 19.1% of children and 33.3% of adolescents (p = 0.065). Diffuse disease (involving all lobes) was seen in 54.5% of infants, 52.5% of children and 10% of adolescents (p = 0.033).
Conclusion: Infants had the most chest X-ray findings, with peribronchial thickening followed by ground-glass opacities being the most common.
Contribution: The findings suggest difference neither between Omicron and preceding waves nor between this study and previously published data.