Comparative Analysis of Pulmonary Lesions in Pediatric COVID-19: Insights from Chest CT Scans and Systematic Review Correlations

Background COVID-19 in children presents with varying severity. Identifying characteristic chest CT features is essential for accurate diagnosis and screening. This study aimed to evaluate CT patterns in pediatric COVID-19 cases to enhance diagnostic accuracy. Study Design: This retrospective cross-sectional study analyzed chest CT scans of 42 children with confirmed COVID-19 at Children's Hospital, Gorgan, Iran. A 14-item checklist assessed demographics, lung involvement, and radiological features. Descriptive statistics and Fisher's exact test were used for analysis. Results Ground-glass opacities (GGO) were the most common finding (92.9%), followed by consolidation (54.8%). Both were significantly associated with peripheral distribution (p < 0.001) and lower zone involvement (p < 0.001 for GGO, p ≈ 0.002 for consolidation). Lesions affected peripheral lung zones (45.24%) or both central and peripheral zones (40.48%), with consolidation predominantly in the latter (p < 0.001). Notably, 7.1% of children had no visible lung lesions. Cases with < 25% lung involvement showed significant correlation with GGO (p < 0.001). Pleural effusion was observed in 4.8%, while pericardial effusion and mediastinal lymphadenopathy were absent. Conclusion Pediatric COVID-19 commonly presents with GGO, consolidation, and peripheral lung lesions. The rarity of certain findings compared to adults may refine diagnostic strategies. These insights could aid in developing AI-based tools for interpreting pediatric COVID-19 chest CT scans.