- The study examined 20 pediatric patients with COVID-19 infection confirmed by testing, analyzing their clinical features, lab results, and chest CT scans.
- Key findings included higher rates of procalcitonin elevation and coinfection compared to adults, as well as consolidation with surrounding halo signs on CT scans.
- The results suggest underlying coinfection may be more common in pediatric COVID-19 patients than adults, and consolidation with halo is a typical sign.
Clinical Study of Foreign Bodies in Tracheo-Bronchialtree with Specific Atten...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Clinical Study of Foreign Bodies in Tracheo-Bronchialtree with Specific Atten...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Các xoang có nhiệm vụ làm ấm không khí, là một bộ phận quan trọng tham gia vào hoạt động hô hấp của cơ thể. Nếu bạn để xoang bị tắc nghẽn, viêm nhiễm trong thời gian dài sẽ dẫn đến tình trạng xuất hiện mủ. Điều này cho thấy bệnh viêm xoang của bạn đang ở mức báo động. Vậy viêm xoang có mủ thực sự nguy hiểm như thế nào? Bài viết này sẽ giúp bạn hiểu rõ hơn về căn bệnh viêm xoang phiền toái này.
Nguồn: Trích https://venusglobal.com.vn/viem-xoang-cap-mu/
#viêm_xoang_mũi_có_mủ
#viêm_xoang_cấp_mủ
#viêm_xoang_hốc_mủ
#viêm_xoang_mủ_cấp
A Study On Clinical Profile Of Sepsis Patients In Intensive Care Unit Of A Te...dbpublications
Background : Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection which is one of the most important cause of mortality & morbidity in critically ill patients. In this study clinical profiles of the sepsis patients admitted in ICU in this part of India have been evaluated. Methods & Materials: This prospective hospital based observational study was undertaken in the department of Emergency Medicine ICU of Gauhati Medical College & Hospital, over a period of one year from August 2014 to July 2015 after obtaining institutional ethical committee clearance.
RESULTS: Clinical profiles of 50sepsis patients, with male preponderance (56%) & mortality rate 36% were studied. Mean age was 48.36 years (SD ±17.16). fever & tachycardia were present in all patients. 30 patients (60%) required ventilatory support, 28 patients (56%) required inotropic support, 10 patients (20%) required dialysis. Gram negative bacteria were found to be the predominant pathogens associated with sepsis(73.4%) where most common organism responsible was Klebsiella (36.8%). Conclusion : assessment of clinical signs & initial serological & radiological investigations are of utmost importance to detect more critically ill patients as early as possible to intervene earlier for saving the life of the sepsis patients.
Background: The incidence of abdominal tuberculosis is increasing. Preoperative diagnosis continues to
be the biggest challenge. Diagnosis is established only after histopathological examination. The modes of presentation
and therapeutic options need to be assessed. Objectives: To study the patterns of presentations, the extent of organ
involvement and therapeutic options. Materials and methods: Fifty histopathologically proven cases of abdominal
tuberculosis were studied. In addition, epidemiologic data, clinical patterns of presentation, diagnostic and various
surgical options, including outcomes, were studied. Results: The mortality in the study was 8%. The disease was
commonly seen in 21 to 40 years old and commonly seen in females. HIV positivity, anaemia and hypoproteinaemia
were associated with poor outcomes. Four types of presentations were observed. Diagnostic laparoscopy enabled early
histopathological diagnosis of biopsy specimens. Chemotherapy is the mainstay of treatment Surgery is a significant
adjunct in diagnosing and managing complications. Patients presenting with perforative peritonitis had a poor prognosis
Conclusion: Critical evaluation of chronic abdominal pain is essential. Supportive evidence such as the history of TB or
contact with a patient suffering from TB is highly suggestive of abdominal tuberculosis. Radiological tests are highly
suggestive but not diagnostic. Diagnostic laparoscopy enables tissue diagnosis. Chemotherapy accompanied by surgical
intervention for complications is the mainstay of treatment.
This study was performed Department of Otor hinolaryngology, Jubilee Mission Medical College, thrissur, Kerala for a period of 2 years commencing from December 2012 to November 2014. To review our experience with deep neck space infections and to study changing trends. The objectives were to study clinical presentation, etiology, associated systemic diseases, bacteriology, radiology, management and outcome of deep neck space infections.40 Patients coming from both urban and rural areas irrespective of age and sex admitted in department of ENT with deep neck space infections which was confirmed either clinically or radiologically. Superficial skin abscesses and abscesses due to infections of external neck injuries were excluded from the study \r\n.
Study of some Pulmonary Function Tests in Children with Sickle Cell Anemia: C...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Các xoang có nhiệm vụ làm ấm không khí, là một bộ phận quan trọng tham gia vào hoạt động hô hấp của cơ thể. Nếu bạn để xoang bị tắc nghẽn, viêm nhiễm trong thời gian dài sẽ dẫn đến tình trạng xuất hiện mủ. Điều này cho thấy bệnh viêm xoang của bạn đang ở mức báo động. Vậy viêm xoang có mủ thực sự nguy hiểm như thế nào? Bài viết này sẽ giúp bạn hiểu rõ hơn về căn bệnh viêm xoang phiền toái này.
Nguồn: Trích https://venusglobal.com.vn/viem-xoang-cap-mu/
#viêm_xoang_mũi_có_mủ
#viêm_xoang_cấp_mủ
#viêm_xoang_hốc_mủ
#viêm_xoang_mủ_cấp
A Study On Clinical Profile Of Sepsis Patients In Intensive Care Unit Of A Te...dbpublications
Background : Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection which is one of the most important cause of mortality & morbidity in critically ill patients. In this study clinical profiles of the sepsis patients admitted in ICU in this part of India have been evaluated. Methods & Materials: This prospective hospital based observational study was undertaken in the department of Emergency Medicine ICU of Gauhati Medical College & Hospital, over a period of one year from August 2014 to July 2015 after obtaining institutional ethical committee clearance.
RESULTS: Clinical profiles of 50sepsis patients, with male preponderance (56%) & mortality rate 36% were studied. Mean age was 48.36 years (SD ±17.16). fever & tachycardia were present in all patients. 30 patients (60%) required ventilatory support, 28 patients (56%) required inotropic support, 10 patients (20%) required dialysis. Gram negative bacteria were found to be the predominant pathogens associated with sepsis(73.4%) where most common organism responsible was Klebsiella (36.8%). Conclusion : assessment of clinical signs & initial serological & radiological investigations are of utmost importance to detect more critically ill patients as early as possible to intervene earlier for saving the life of the sepsis patients.
Background: The incidence of abdominal tuberculosis is increasing. Preoperative diagnosis continues to
be the biggest challenge. Diagnosis is established only after histopathological examination. The modes of presentation
and therapeutic options need to be assessed. Objectives: To study the patterns of presentations, the extent of organ
involvement and therapeutic options. Materials and methods: Fifty histopathologically proven cases of abdominal
tuberculosis were studied. In addition, epidemiologic data, clinical patterns of presentation, diagnostic and various
surgical options, including outcomes, were studied. Results: The mortality in the study was 8%. The disease was
commonly seen in 21 to 40 years old and commonly seen in females. HIV positivity, anaemia and hypoproteinaemia
were associated with poor outcomes. Four types of presentations were observed. Diagnostic laparoscopy enabled early
histopathological diagnosis of biopsy specimens. Chemotherapy is the mainstay of treatment Surgery is a significant
adjunct in diagnosing and managing complications. Patients presenting with perforative peritonitis had a poor prognosis
Conclusion: Critical evaluation of chronic abdominal pain is essential. Supportive evidence such as the history of TB or
contact with a patient suffering from TB is highly suggestive of abdominal tuberculosis. Radiological tests are highly
suggestive but not diagnostic. Diagnostic laparoscopy enables tissue diagnosis. Chemotherapy accompanied by surgical
intervention for complications is the mainstay of treatment.
This study was performed Department of Otor hinolaryngology, Jubilee Mission Medical College, thrissur, Kerala for a period of 2 years commencing from December 2012 to November 2014. To review our experience with deep neck space infections and to study changing trends. The objectives were to study clinical presentation, etiology, associated systemic diseases, bacteriology, radiology, management and outcome of deep neck space infections.40 Patients coming from both urban and rural areas irrespective of age and sex admitted in department of ENT with deep neck space infections which was confirmed either clinically or radiologically. Superficial skin abscesses and abscesses due to infections of external neck injuries were excluded from the study \r\n.
Study of some Pulmonary Function Tests in Children with Sickle Cell Anemia: C...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Characteristics of pediatric SARS CoV-2 infection and potential evidence for ...Rosmirella Cano Rojas
We report epidemiological and clinical investigations on ten
pediatric SARS-CoV-2 infection cases confirmed by realtime
reverse transcription PCR assay of SARS-CoV-2 RNA.
Symptoms in these cases were nonspecific and no children
required respiratory support or intensive care. Chest X-rays
lacked definite signs of pneumonia, a defining feature of the
infection in adult cases. Notably, eight children persistently
tested positive on rectal swabs even after nasopharyngeal
testing was negative, raising the possibility of fecal–oral
transmission.
Background: Cervical screening through conventional cervical cytology is most commonly used throughout the world. The Cervical cancer is the second most common cancer worldwide and in developing countries, the leading cause of death. It is one of the most preventable and curable of all cancers.
Objective: To Study the role of Pap smear in detecting neoplastic and non-neoplastic lesions of cervix and to determine the occurrence of various lesions in remote area of Bagalkot.
Methods: This is prospective study of 240 women with age group 20 to 60 years was carried out from May 2015 to June 2016 cytology section of pathology department, S. Nijalingappa Medical College & H.S.K Hospital & Research Centre, Bagalkot, India. Pap smears were prepared, fixed, stained and carefully examined.
Results: In this study, Reactive cellular changes associated with inflammation was the most common with 182 cases (75.8%) followed by Low-grade squamous intraepithelial lesions (SIL) with 11 cases (4.5%), then atypical squamous epithelial cells of undetermined significance 8 cases (3.3%), High-grade squamous intraepithelial lesions with 5 cases (2.1%), Atrophy with 3 cases (1.3%) and Atypical Glandular Cell in 3 cases (1.3%). The average age of women for all the epithelial abnormalities was 40 years.
Conclusion: This study will increase awareness of the Pap test and cervical cancer, thereby paving a way for the prevention of cervical cancer.
Key-words- Pap smear, Cervical cancer, The Bethesda System, Squamous intraepithelial lesions (SIL)
Upsurge of Cases of Lichen Planus in Iraqi Population in Baghdad City with Fr...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Patients Knowledge and Attitude towards Tuberculosis in a Rural Setting in Al...inventionjournals
Introduction: Tuberculosis is a major cause of illness worldwide. The burden is rising globally due to poverty, increasing population and HIV/AIDS. In developing countries, poor knowledge and perception of tuberculosis is prevalent, which causes delay in diagnosis and treatment of tuberculosis..India has the highest number of TB cases in the world. Material and Methods: The present study was conducted in Rural Health Training Centre, Jawan, of Jawahar Lal Nehru Medical College,AMU, Aligarh .A semi structured questionnaire was used to collect data from January- March,2015. A total of 80 subjects ,more than 15 years age group,residents of Jawan,were selected who either had completed tuberculosis treatment or are still on treatment.An informed consent was taken,before starting the questionnaire. Results: shows that out of 80 subjects under study,50% were in age –group 35 to 55 years and 75 % were males. Radio/T.V. was the maximum source of information on tuberculosis (60%), followed by health workers or community workers(50%) .Few subjects got information about T.B. from family members and friends/neighbours. 87.5% of the subjects were aware of the evening rise of temperature inT.B., followed by blood in sputum(80%) and cough more than 3 weeks(42.5%).Regarding causes of T.B.,76.25% of the subjects said that T.B. was due to smoking, followed by alcohol consumption(42.5%). 85% of the subjects knew that T.B. was a communicable disease.70% of the subjects knew that the mode of transmission of T.B. was during coughing.50% of the subjects believed that tuberculosis could be transmitted by sharing of common materials with T.B. patients.70% of the subjects reported that BCG immunization prevented tuberculosis. More than half(55%) of the participants reported that the transmission of T.B. could be prevented by avoiding personal contact with the T.B. patient. Conclusion: The study showed that the knowledge of people relating to T.B. is insufficient in most of the aspects.TB awareness programs should focus on reduction of TB associated stigmas.We need to train our health workers and also educate our masses especially those living in rural areas
Cryptic Disseminated Tuberculosis: a Secondary Analysis of Previous Hospital-...fahmi khan
The main purpose of this study was to describe the demographic and clinical features of cryptic disseminated TB; it was also aimed to shed light on diagnostic test, procedure results, organ involvement, and outcomes of cryptic disseminated TB in patients with confirmed disseminated TB.
Red cell alloimmunization in blood transfusion dependent Patients with Sickle...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
The STUDY of the DISTRIBUTION & DETERMINANTS of HEALTH-RELATED STATES in specified POPULATIONS, and the application of this study to CONTROL of health problems.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
2. wild spread to other 24 countries, such as Japan, Singapore, Thailand,
North Korea, and so on.3
In the early days of a COVID‐19 infection outbreak, pediatric
patients were rather rare, who were thought to be not susceptible to
it. However, along with the emerging of familial aggregation, children
suffered from COVID‐19 infection were gradually appeared. Also,
neonates who born to mothers with COVID‐19 infection were in
concern. As a pediatric group is usually susceptible to upper re-
spiratory tract infection, because of their developing immune system,
the delayed presence of pediatric patients is confusing. Otherwise,
under the circumference of wildly spread of COVID‐19 and low de-
tection rate by pharyngeal swab COVID‐19 nucleic acid test, how to
distinguish it from other common respiratory tract infection patho-
gens in pediatric patients is still a problem. Whether it shares the
same imaging pattern of adults is also an important issue.
As the clinical and imaging features of pediatric patients
with COVID‐19 infection were limited, we would like to present a
series of 20 cases who have been identified by the pharyngeal swab
COVID‐19 nucleic acid test.
2 | MATERIALS AND METHODS
2.1 | Subjects
Twenty pediatric inpatients with COVID‐19 infection confirmed by
pharyngeal swab COVID‐19 nucleic acid test from 23 January to
8 February in Wuhan Children's Hospital were included in this study.
All the patients are in accordance to the “Diagnosis and Treatment
Protocol for COVID‐19 (Fifth Revised Edition)” distributed by the
National Health Commission.4
2.2 | Data collection
Clinical charts data including demography information, contact
history, previous history, clinical symptoms, laboratory findings, and
coinfection which defined as a concurrent infection of a patient
with two or more pathogens simultaneously. The hospital stays were
updated to 18 February 2020.
The chest computed tomography (CTs) were obtained from all
subjects, as the plain chest X‐ray cannot exclude the existence of
pulmonary lesions, especially for the patients without symptoms and
mild cases. For all the patients, noncontrast chest CT studies were
performed on SOMATOM Definiton AS 128 unit (Siemens medical
system; Siemens, Germany) with the following parameters: 12 0 kV,
100 to 150 mA, 0.6‐mm collimation, and 1:1 pitch. The scanning
range covered from lung apex to diaphragm on axial plane taken
under free breathing with the patients in the supine position. Thin‐
section CT images were reconstructed with 1.25‐mm collimation with
a standard algorithm and then sent to the picture archiving and
communication system (PACS) for analyzing. CT images were eval-
uated using a lung window with a window level of −600 HU and
window width of 1500 HU, and the soft‐tissue window with a win-
dow level of 40 HU and window width of 300 HU. If necessary,
0.50 mL/kg body mass of 10% chloral hydrate was taken orally be-
fore the examination. All the images were stored in PACS and re-
viewed by two experienced pediatric radiologists. The CT features
were evaluated as follows: (a) ground‐glass opacities, (b) consolida-
tions with surrounding halo sign, (c) nodules, (d) fine mesh shadow,
(e) pleural effusion, (f) lymphadenopathy, (g) unilateral or bilateral, (h)
subpleural or nonsubpleural, and (i) residual fiber strips.
Pharyngeal swab samples of all the subjects in this group were
collected, and the COVID‐19 RNA was identified by a reverse
transcription‐polymerase chain reaction.
The protocol for this retrospective study was approved by the
Ethics Committee of Wuhan Children's Hospital and the written in-
formed consent was waived for emerging infectious diseases.
3 | RESULTS
The clinical features of pediatric patients with COVID‐19 infection
were displayed in Table 1. In this study, 13 patients were male (13/20,
TABLE 1 Summary of patient characteristics (n = 20)
Characteristic Number (%)
Sex
Boy 13 (65%)
Girl 7 (35%)
Age
<1 mo 3 (15%)
1 mo to 1 y 6 (30%)
1‐3 y 5 (25%)
3‐6 y 3 (15%)
>6 y 3 (15%)
Contact history
Yes 13 (65%)
Uncertainty 7 (35%)
Symptom
Fever 12 (60%)
Cough 13 (65%)
Diarrhea 3 (15%)
Nasal discharge 3 (15%)
Sore throat 1 (5%)
Fatigue 1 (5%)
Vomiting 2 (10%)
Tachypnea 2 (10%)
Other findings
Sinus tachycardia 1 (5%)
Epilepsy as a sequela of previous viral encephalitis 1 (5%)
History of atrial septal defect surgery 2 (10%)
Atrial arrhythmia 1 (5%)
First‐degree atrioventricular block, atrial and
ventricular premature beat
1 (5%)
Incomplete right bundle‐branch block 1 (5%)
2 | XIA ET AL.
3. 65%) and 7 were female (7/20, 35%). Patient ages ranged from 1 day
to 14 years 7 months, with a median age of 2 years and 1.5 months.
Thirteen pediatric patients (13/20, 65%) had an identified history of
close contact with COVID‐19 diagnosed family members. The clinical
manifestations included fever which defined as axillary temperature
over 37.3°C in 12 cases (12/20, 60%), cough in 13 cases (13/20, 65%),
diarrhea in 3 cases (3/20, 15%), nasal discharge in 3 cases (3/20, 15%),
sore throat in 1 case (1/20, 5%), vomiting in 2 cases (2/20, 10%),
tachypnea in 2 cases (2/20, 10%), and fatigue in 1 case (1/20, 5%).
Most of the children did not have positive pulmonary signs, moist rales
were found in three cases (3/20, 15%), retraction signs were found in
one case (1/20, 5%), and cyanosis was found in one case (1/20, 5%).
Laboratory findings were shown in Table 2. White blood cell
count was normal in 14 cases (14/20, 70%), decreased in 4 cases
(4/20, 20%), and increased in 2 cases (2/20, 10%); percentage of
lymphocyte decreased in 7 cases (7/20, 35%) and increased in 3 cases
(3/20, 15%); alanine aminotransferase increased in 5 cases (5/20,
25%); creatine kinase‐MB increased in 15 cases (15/20, 75%);
C‐reactive protein (CRP) increased in 9 cases (9/20, 45%); and
procalcitonin (PCT) increased in 16 cases (16/20, 80%). Eight patients
were coinfected with other pathogens (8/20, 40%), including
influenza viruses A and B, mycoplasma, respiratory syncytial virus,
and cytomegalovirus. Furthermore, four cases had abnormal
electrocardiogram events. Two patients have a history of atrial septal
defect surgery and one with epilepsy as a sequela of previous viral
encephalitis.
To the best of our knowledge, the result of COVID‐19 RNA
detection could be a false negative at an early stage. As most of the
pediatric patients were not severe, plain chest X‐ray could not
identify all the pulmonary lesions, chest CTs were obtained to pro-
vide support information for diagnosis and management.
According to the “Diagnosis and Treatment Protocol for COVID‐19
(Fifth Revised Edition),”4
the imaging manifestations of chest CTs
obtained in this study were divided into four stages, as follows:
Early stage: 6 patients presented with unilateral pulmonary
lesions (6/20, 30%), 10 presented with bilateral pulmonary lesions
(10/20, 50%), and 3 neonates and 1 child showed no abnormality on
chest CT (4/20, 20%). Subpleural lesions with localized inflammatory
infiltration were found in all children (Figure 1A). Consolidation with
surrounding halo sign was observed in 10 patients (10/20, 50%),
ground‐glass opacities were observed in 12 patients (12/20, 60%),
fine mesh shadow was observed in 4 patients (4/20, 20%), and tiny
TABLE 2 Laboratory information of pediatric patients with
COVID‐19 infection
Parameter Number of patients (%)
WBC, ×109
/L
<5.50 4 (20%)
5.50‐12.20 14 (70%)
>12.20 2 (10%)
L%
<45 7 (35%)
45‐65 10 (50%)
>65 3 (15%)
CRP, mg/L
≤3 13 (65%)
>3 7 (35%)
PCT, mg/L
≤0.05 4 (20%)
>0.05 16 (80%)
ALT, IU/L
≤40 15 (75%)
>40 5 (25%)
CK‐MB, IU/L
≤25 15 (75%)
>25 5 (25%)
Coinfection pathogen
Cytomegalovirus 1 (5%)
Influenza B virus 2 (10%)
Influenza A virus 1 (5%)
Mycoplasma 4 (20%)
Respiratory syncytial virus 1 (5%)
Abbreviations: ALT, alanine aminotransferase; CK‐MB, creatine
kinase‐MB; CRP, C‐reactive protein; L%, percentage of lymphocyte;
PCT, procalcitonin; WBC, white blood cell.
FIGURE 1 A, Female, 14 years old. Chest CT showed scattered ground‐glass opacities in the inferior lobe of the right lung, located
subpleural or extended from subpleural lesions. B, Male, 10 years old. Chest CT showed consolidation with halo sign in the inferior lobe of the
left lung surrounded by ground‐glass opacities. C, Male, 1 year old. Chest CT showed diffused consolidations and ground‐glass opacities in both
lungs, with a "white lung" appearance of the right lung. CT, computed tomography
XIA ET AL. | 3
4. nodules were observed in 3 patients (3/20, 15%) (Table 3). Chest CT
showed no signs of pleural effusion and lymphadenopathy.
Advanced stage: Chest CT mainly showed that the scope of the
lesion expanded and the density increased, which could involve multiple
lobes of both lungs and distributed in multiple places. Ground‐glass
opacities and consolidation coexist and may be accompanied by
interlobular septal thickening, fibrosis lesions, or air bronchogram signs
(Figure 1B).
Critical stage: In the case of further development of the lesion, the
chest CT showed that the consolidation lesions were diffuse and in-
volved both lungs, presenting as a "white lung" change, accompanied by
air bronchogram sign. The lesion density was heterogeneous, accom-
panied by ground‐glass opacities and pleural thickening (Figure 1C).
Recovery stage: After treatment, a chest CT follow‐up was ob-
tained in six cases. Lesions were completely absorbed in two cases
(2/20, 10%) (Figures 2A and 2D), consolidations turned into ground‐
glass opacities and gradually decreased in three cases (3/20, 15%)
(Figures 2B and 2E), and residual fiber strip remained in three cases
(3/20, 15%) (Figures 2C and 2F).
All the patients had been treated in the isolation ward of Wuhan
Children's Hospital. Eighteen patients were cured and discharged
with an average stay of 12.9 days (8‐20 days). Two asymptomatic
neonates were still under observation because of positive results
from the pharyngeal swab COVID‐19 nucleic acid test, with negative
CT findings.
4 | DISCUSSION
COVID‐19 viral pneumonia is an acute infectious respiratory disease
caused by a novel coronavirus. By the beginning of February 2020,
nearly 30 000 cases had been confirmed nationwide, while the actual
number would be larger.5
The virus can be transmitted by an infected
person or an asymptomatic carrier and is a highly contagious disease.
Respiratory droplets are the main route of transmission, but can also
be transmitted by contact and digestive tract.6
The incubation period
is about 1 to 14 days, and is supposed could be up to 24 days. Crowds
are generally susceptible to COVID‐19. Most of the cases are mild,
but the elderly or those with underlying diseases are more likely to
TABLE 3 CT imaging findings in 20 patients with COVID‐19
pneumonia in early stage
Findings Number of patients (%)
Pulmonary lesions
Null 4 (20%)
Unilateral 6 (30%)
Bilateral 10 (50%)
Subpleural lesions
Seen 20 (100%)
Not seen 0 (0%)
Consolidation with surrounding
halo sign
10 (50%)
Ground‐glass opacities 12 (60%)
Fine mesh shadow 4 (20%)
Tiny nodules 3 (15%)
Abbreviations: COVID, coronavirus; CT, computed tomography.
FIGURE 2 A, Male, 3 years old. On admission, chest CT showed consolidation in the posterior segment of the upper lobe of the left lung with
a surrounded halo sign. B, Female, 8 years old. On admission, chest CT showed patchy consolidation with halo sign in the basal segment of the
inferior lobe of the right lung, and ground‐glass opacities in the inferior lobe of the left lung. C, Male, 14 years old. On admission, chest CT
showed consolidation with halo sign in the lingular segment of the left lung, and fibrous cords in both lungs. D, The same patient of (A), 11 days
after admission, chest CT showed that the consolidation in the posterior segment of the upper lobe of the left lung was disappeared. E, The
same patient of (B), 4 days after admission, chest CT showed shrunken lesions with lower density in the inferior lobes of both lungs. F, The same
patient of (C), 3 days after admission, chest CT showed a contraction of consolidation in lingular segment of the left lung, the disappearance of
halo sign, and fibrous cords left in both lungs. CT, computed tomography
4 | XIA ET AL.
5. develop to severe stage.7
The lack of children samples in the pre-
viously reported studies may be related to the children staying at
home during the Spring Festival holiday and having less contact with
the source of infection.
The clinical manifestations of children patients are similar to
those of adults, such as fever and cough. A few children have diar-
rhea and runny nose, but the overall symptoms are relatively mild.
Thirteen pediatric patients, including three neonates, had an identi-
fied history of close contact with COVID‐19 diagnosed family
members, who were undergone the COVID‐19 RNA detection.
Although the results in three neonates were positive, no lesion was
found on chest CT, repeated COVID‐19 RNA detection should be
carried out for excluding the possibility of a contaminated sample
and other reasons. As no evidence of vertical transmission has been
confirmed in the previous study,8
close contacts may be the possible
explanation for the positive result in our study. Remarkably, 7 of
20 patients had a previous history of congenital or acquired diseases,
which may indicate that children with underlying diseases may be
more susceptible to COVID‐19 infection. Overall, pediatric patients
generally have a good prognosis with an average hospital stay of
12.9 days.
PCT is a marker for bacterial infection which could be induced by
bacteriotoxin but suppressed by interferon.9
It is worth noting that
the PCT was elevated in 80% cases in this study, no matter coin-
fection evidence existed or not, which is not common in adult pa-
tients. It may suggest that routine antibacterial treatment should be
considered in pediatric patients, as the coinfection was common in
our cases (40%).
In most cases of this study, abnormal laboratory results may
prompt clinicians to further screen the nucleic acid detection of
COVID‐19 virus. In a clinical setting, pharyngeal swab COVID‐19
virus nucleic acid detection is an important basis for diagnosis.
However, due to the limitation of sampling materials, especially in the
early stage of the disease, the positive rate is relatively low. There-
fore, early diagnosis is of great significance for further rational
management and clinical treatment of children. Moreover, since most
of the pediatric patients are mild cases, plain chest X‐ray often fails
to show the lesions or the detailed features, leading to misdiagnosis
or missed diagnosis. Therefore, early chest CT examination is very
necessary. In some pediatric patients with a negative nucleic acid of
COVID‐19 virus, we managed them as suspected patients according
to the typical lesions shown on chest CT, which could provide evi-
dence not only for early treatment to the children but also for ef-
fectively isolating the source of infection.
Chest CT findings in children were similar to those in adults, and
most of them were mild cases.10,11
The typical manifestations were
unilateral or bilateral subpleural ground‐glass opacities, and con-
solidations with surrounding halo sign. As consolidations with sur-
rounding halo sign account for up to 50% cases, they should be
considered as typical signs in pediatric patients. Pleural effusion was
not seen. The absorption of lesions on chest CT lagged behind clinical
symptoms and nucleic acid detection. Lesions could be still visible on
chest CT when two consecutive nucleic acid tests were negative.
As for the normal findings in three neonates with a positive nucleic
acid test, whether it was due to the influence of the delivery process
on sampling or the specific CT manifestations for neonates, more
samples are needed for further confirmation.
The CT imaging of COVID‐19 infection should be differentiated
with other virus pneumonias, such as influenza virus, parainfluenza
virus, respiratory syncytial virus, and adenovirus.12
Adenovirus
pneumonia lesions had higher density, more consolidations, and
fewer subpleural lesions. Respiratory syncytial virus and parain-
fluenza virus pneumonia lesions were mostly distributed along the
bronchial tree with a thickened bronchial wall. Influenza viruses
could cause grid‐like changes in the lungs. In addition, it should be
differentiated from bacterial pneumonia, mycoplasma pneumonia,
and chlamydia pneumonia, and the density of pneumonia lesions
caused by the latter pathogens is relatively higher. However, chest
CT manifestations of pneumonia caused by different pathogens
overlap, and COVID‐19 pneumonia can be superimposed with
pneumonia caused by other types of pathogens, presenting more
serious and complex imaging manifestations, so epidemiological and
etiological examination should be combined.
In conclusion, COVID‐19 virus pneumonia in children is mainly
mild, and chest CT can present characteristic changes of subpleural
ground‐glass opacities and consolidations with surrounding halo,
which is an effective means for follow up and evaluating the changes
of lung lesions. In the case that the positive rate of COVID‐19 nucleic
acid test from pharyngeal swab samples is not high, the early de-
tection of lesions by CT is conducive to reasonable management and
early treatment for pediatric patients. However, the diagnosis of
COVID‐19 pneumonia by CT imaging alone is not sufficient enough,
especially in the case of coinfection with other pathogens. Therefore,
early chest CT screening and timely follow‐up, combined with cor-
responding pathogen detection, is a feasible clinical protocol in
children.
CONFLICT OF INTERESTS
The authors declare that there are no conflict of interests.
ORCID
Jianbo Shao http://orcid.org/0000-0002-4224-3057
Yu Guo http://orcid.org/0000-0002-2296-3276
REFERENCES
1. Huang C, Wang Y, Li X, et al. Clinical features of patients infected
with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:
497‐506.
2. Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients
with pneumonia in China, 2019. N Engl J Med. 2020;382:727‐733.
3. Pullano G, Pinotti F, Valdano E, Boelle P‐Y, Poletto C, Colizza V. Novel
coronavirus (2019‐nCoV) early‐stage importation risk to Europe,
January 2020. Euro Surveill. 2020;25:2000057.
4. General Office of the National Health Commission of China. Diagnosis
and Treatment Protocol for 2019‐nCoV. 5th ed. Beijing, China: National
Health Commission of China; 2020.
5. Parry J. Wuhan: Britons to be evacuated as scientists estimate 44 000
cases of 2019‐nCOV in the city. Brit Med J. 2020;368:m351.
XIA ET AL. | 5
6. 6. Riou J, Althaus CL. Pattern of early human‐to‐human transmission of
Wuhan 2019 novel coronavirus (2019‐nCoV), December 2019 to
January 2020. Euro Surveill. 2020;25:7‐11.
7. Hui DS, Azhar EI, Madani TA, et al. The continuing 2019‐nCoV epidemic
threat of novel coronaviruses to global health—the latest 2019 novel
coronavirus outbreak in Wuhan, China. Int J Infect Dis. 2020;91:264‐266.
8. Zhu H, Wang L, Fang C, et al. Clinical analysis of 10 neonates born to
mothers with 2019‐nCoV pneumonia. Transl Pediatr. 2020;9:51‐60.
9. Simon L, Gauvin F, Amre DK, Saint‐Louis P, Lacroix J. Serum pro-
calcitonin and C‐reactive protein levels as markers of bacterial in-
fection: a systematic review and meta‐analysis. Clin Infect Dis. 2004;
39:206‐217.
10. Kanne JP. Chest CT findings in 2019 novel coronavirus (2019‐nCoV)
infections from Wuhan, China: key points for the radiologist.
Radiology. 2020.
11. Song F, Shi N, Shan F, et al. Emerging coronavirus 2019‐nCoV pneu-
monia. Radiology. 2020.
12. Virkki R, Juven T, Rikalainen H, Svedstrom E, Mertsola J,
Ruuskanen O. Differentiation of bacterial and viral pneumonia in
children. Thorax. 2002;57:438‐441.
How to cite this article: Xia W, Shao J, Guo Y, Peng X, Li Z,
Hu D. Clinical and CT features in pediatric patients with
COVID‐19 infection: Different points from adults. Pediatric
Pulmonology. 2020;1–6. https://doi.org/10.1002/ppul.24718
6 | XIA ET AL.