Narrative Review Article: Radiographic Findings in COVID-19 and MIS-C in Children

Abstract

Context: This systematic review explores the radiographic manifestations of coronavirus disease 2019 (COVID-19) and multisystem inflammatory syndrome in children (MIS-C) in pediatric patients. The initial focus of the COVID-19 pandemic was on adults, as it originated from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), leading to insufficient understanding of its effects in children. Most pediatric COVID-19 cases are mild or asymptomatic, but a minority may develop severe pneumonia. Additionally, the potential for children to contribute to virus transmission complicates the dynamics of the pandemic. Evidence Acquisition: A comprehensive literature search was conducted using databases such as PubMed, Scopus, and Google Scholar for articles published between January 2020 and December 2023. The keywords included “COVID-19”, “pediatric”, “MIS-C”, “imaging”, “chest X-ray”, “computed tomography”, and “ultrasound”. Studies included original research articles, review papers, and case series relevant to pediatric imaging in COVID-19 and MIS-C. Articles were selected based on relevance to the topic, availability of full text, and English language. Study quality was evaluated based on design and sample size, and reference lists of key articles were screened for additional relevant studies. Results: This review outlines key radiological findings in pediatric COVID-19, focusing on chest radiography, chest computed tomography (CT), and lung ultrasound (US). The MIS-C, associated with COVID-19, is characterized by severe multi-organ inflammation, necessitating timely imaging for diagnosis and management. Common findings include heart failure and acute respiratory distress syndrome (ARDS). Conclusions: The as low as reasonably achievable (ALARA) principle guides pediatric imaging, emphasizing radiation minimization, with low-dose CT as an alternative. Further research is essential to improve understanding of pediatric COVID-19 and MIS-C.