CT presentations of adult and pediatric SARS-CoV-2 patients: A review of early COVID-19 data.

OBJECTIVE: Initial COVID-19 reports described a variety of clinical presentations, but lower respiratory abnormalities are most common and chest CT findings differ between adult and pediatric patients. We aim to summarize early CT findings to inform healthcare providers on the frequency of COVID-19 manifestations specific to adult or pediatric patients, and to determine if the sensitivity of CT justifies its use in these populations. METHODS: PubMed was searched for the presence of the words "CT, imaging, COVID-19" in the title or abstract, and 17 large-scale PubMed and/or Scopus studies and case reports published between January 1, 2020 and April 15, 2020 were selected for data synthesis. RESULTS: Initial CT scans identified ground-glass opacities and bilateral abnormalities as more frequent in adults (74%, n = 698, and 89%, n = 378, respectively) than children (60%, n = 25, and 37%, n = 46). At 14+ days, CT scans evidenced varied degrees of improvement in adults but no resolution until at least 26 days after the onset of flu-like symptoms. In pediatric patients, a third (n = 9) showed additional small nodular GGOs limited to a single lobe 3-5 days after an initial CT scan. CONCLUSION: Early adult CT findings suggest the limited use of CT as a supplemental tool in diagnosing COVID-19 in symptomatic adult patients, with a particular focus on identifying right and left lower lobe abnormalities, GGOs, and interlobular septal thickening. Early pediatric CT findings suggest against the use of CT if RT-PCR is available given its significantly lower sensitivity in this population and radiation exposure.

[CT Presentations of Adult and Pediatric SARS-COV-2 Patients: A Review of Early COVID-19 Data]. / Comparación de los hallazgos en la tomografía computarizada de pacientes adultos y pediátricos con COVID-19.

Objective: Initial COVID-19 reports described a variety of clinical presentations, but lower respiratory abnormalities are most common and chest CT findings differ between adult and pediatric patients. We aim to summarize early CT findings to inform healthcare providers on the frequency of COVID-19 manifestations specific to adult or pediatric patients, and to determine if the sensitivity of CT justifies its use in these populations. Methods: PubMed was searched for the presence of the words "CT, imaging, COVID-19" in the title or abstract, and 17 large-scale PubMed and/or Scopus studies and case reports published between January 1, 2020 and April 15, 2020 were selected for data synthesis. Results: Initial CT scans identified ground-glass opacities and bilateral abnormalities as more frequent in adults (74%, n = 698, and 89%, n = 378, respectively) than children (60%, n = 25, and 37%, n = 46). At 14+ days, CT scans evidenced varied degrees of improvement in adults but no resolution until at least 26 days after the onset of flu-like symptoms. In pediatric patients, a third (n = 9) showed additional small nodular GGOs limited to a single lobe 3-5 days after an initial CT scan. Conclusión: Early adult CT findings suggest the limited use of CT as a supplemental tool in diagnosing COVID-19 in symptomatic adult patients, with a particular focus on identifying right and left lower lobe abnormalities, GGOs, and interlobular septal thickening. Early pediatric CT findings suggest against the use of CT if RT-PCR is available given its significantly lower sensitivity in this population and radiation exposure.

Bringing comprehensive health education to the New York City Public Schools: a private-public success story.

The New York Academy of Medicine has pioneered a far-sighted effort which successfully introduced two model health education curricula into the New York City Public Schools at both the elementary and middle school levels. The curriculums for kindergarten through sixth grades, Growing Healthy, are currently being used in 525 of New York's 625 elementary schools, and the curriculum for seventh and eighth grades, Being Healthy, is in place in 60 of 200 junior high schools. These curricula offer a comprehensive approach to health education that promotes emotional well-being as well as physical health by improving health behaviors, attitudes, and academic performance of students through hands-on and interactive activities which develop decision-making skills and the ability to make healthful choices. The program has met with ongoing success and expanding influence, as the result of several important factors. First, the New York Academy of Medicine took a leadership role in supporting a venture outside its own walls and became an active advocate for comprehensive health education in the public schools. The Academy's standing as a prestigious yet independent medical association brought influence to the organizing efforts and contributed the credibility needed to get the program off the ground. Second, the Division of Student Support Services of the New York City Public Schools gave strong acceptance and cooperation leading to ongoing financial support and institutionalization of the program. Added to that is the enthusiasm of teachers, administrators, and other in-school personnel who have made the lessons of Growing Healthy and Being Healthy meaningful by reaching hundreds of thousands of students across New York City. Another important factor is the oversight and longevity which has been provided by the unusual gathering of doctors, educators, public health specialists, funders, and city administrators who created an effective private-public coalition 15 years ago and have remained committed to working together. Last through its ongoing efforts, the Academy's Office of School Health Programs has stayed at the forefront of developments in health education. By continuing to evaluate their activities and by constantly integrating new materials into the existing curricular framework, they have demonstrated that a comprehensive health education program can be both meaningful to children and responsive to community needs by reflecting current public health issues and concerns.