RESUMO
BACKGROUND: Although it was assumed in the early stages of the coronavirus disease 2019 (COVID-19) outbreak that the novel coronavirus infection was uncommon among children, the number of infected children has since been increasing significantly. Real-time polymerase chain reaction (RT-PCR) is the gold standard modality for the diagnosis of COVID-19 infection. In adults, chest CT is performed as an adjunct for identifying suspected COVID-19 cases along with patients' management and follow-up. However, CT findings in COVID-19 children studies have shown a diverse incidence of abnormal CT and finding patterns that made CT scan necessity to have remained controversial. The aim of the present review was to comprehensively determine the imaging findings of chest CT scans of confirmed COVID-19-infected pediatric patients through a systematic review of the available published studies. METHODS: A systematic literature search was performed in the PubMed, Embase, Scopus, and Web of Science core collection databases (four databases including SSCI, SCIE, AHCI, and ESCI) to find original articles containing chest CT findings in children with COVID-19 through May 7, 2021. This review included 81 articles published in English that in total included 3,557 pediatric patients. RESULTS: This review included 81 articles published in English that in total included 3,557 pediatric patients. Among the total confirmed coronavirus-infected cases (via RT-PCR test), two-thirds had abnormal chest CT findings; among these patients, 549 (37.8%) had bilateral lung involvement, and 475 (32.7%) had unilateral disease. Regarding the types of lung lesions, ground glass opacities were observed in 794 (54.7%) of patients, and consolidation was observed in 10.2%; moreover, halo sign, discrete pulmonary nodules, interstitial abnormalities or reticulations, and vascular thickening shadows were reported in 7.4%, 2.6%, 9.7% and 1.7% of the patients, respectively. DISCUSSION: This review revealed that chest CT scan manifestations in majority of COVID-19 positive children are mild, so regarding the risk of radiation exposure, it is reasonable to confine CT scan to individual cases that its benefits outweigh the risks.
RESUMO
BACKGROUND: Osteomalacia and osteoporosis are a common clinical problem in patients with beta thalassemia major. The purpose of this study is to assess the possible correlation of excess iron in liver and heart of beta thalassemia patient with bone mineral density (BMD). MATERIALS AND METHODS: We performed a prospective cross-sectional study on 80 patients with beta thalassemia major and inermedia. The patients were stratified into normal BMD and those with abnormal BMD test based on T-score. All patients underwent magnetic resonance imaging examinations of heart and liver. Multi-echo fast gradient-echo sequence was used and T2* values were calculated based on the Royal Brompton Hospital protocol. Correlations between T2* values in heart and liver as well as serum ferritin levels with femoral and lumbar BMD were investigated. RESULTS: There were no significant differences between patients with and without osteopenia or osteoporosis with respect to age and sex. Patients with abnormal BMD had lower T2* values in the heart. Serum ferritin and heart iron load (based on T2*) were negatively correlated with BMD. CONCLUSION: Serum ferritin and heart iron content are good indicators of BMD in patients with beta thalassemia major and intermedia.