Published online Sep 25, 2022. doi: 10.5501/wjv.v11.i5.331
Peer-review started: April 24, 2022
First decision: May 12, 2022
Revised: June 1, 2022
Accepted: August 25, 2022
Article in press: August 25, 2022
Published online: September 25, 2022
Coronavirus disease 2019 (COVID-19) is a pandemic caused by the severe acute respiratory syndrome coronavirus in 2019. Although the real-time reverse tr-anscription PCR test for viral nucleic acids is the gold standard for COVID-19 diagnosis, computed tomography (CT) has grown in importance.
To evaluate the sensitivity and specificity of thoracic CT findings of COVID-19 pneumonia according to age groups.
PCR and CT results from 411 patients were reviewed. The diagnosis of COVID-19 pneumonia was made by three radiologists. Lymphadenopathy, pericardial effusion, pleurisy, pleural thickening, pleural effusion, location features of the lesions, ground glass, consolidation, air bronchogram, vascular enlargement, bronchial dilatation, halo finding, inverted halo sign, nodularity, air bubble, subpleural band (curvilinear density), reticular density, crazy paving pattern, and fibrosis findings were recorded. The patients were divided into nine groups by decades while calculating the sensitivity, specificity, and diagnostic efficacy for CT positivity.
The mean age of the cases was 48.1 ± 22.7 years. The CT finding with the highest diagnostic power was ground glass. Vascular enlargement and bronchial dilatation followed ground glass. Peri-cardial effusion was the finding with the lowest diagnostic accuracy. The incidence of lymphadenopathy, pleurisy, pleural thickening, peripheral localization, bilateral, ground glass, vascular enlargement, bronchial dilatation, subpleural band, reticular density, crazy paving appearance, and fibrosis all increased increase significantly with age in patients with positive real-time reverse transcription PCR test.
There are few publications comparing sensitivity and specificity of thoracic CT findings according to age. In cases of COVID-19 pneumonia, there is an increase in the variety and frequency of CT findings with age, and parallel to this the sensitivity and specificity of the findings increase. COVID-19 cases in the pediatric age group have fewer lung findings than adults, and this situation decreases the diagnostic value of CT in pediatric patients.
Core Tip: Despite its high sensitivity for identifying coronavirus disease 2019 (COVID-19) pneumonia, the diagnostic potential of computed tomography findings has not been thoroughly investigated, particularly in relation to age subgroups. It is worth noting that the prevalence of COVID-19 pneumonia can vary by age. Even common results, such as ground glass opacities, can be reduced in younger individuals, particularly in the pediatric population. Additionally, the findings of this study may raise awareness about the proper use of computed tomography scans in children and contribute to radiation protection by limiting computed tomography scans in age groups with low sensitivity.