Pleural effusion was detected in 2 patients (8.7%), but only 1 had this sign as an isolated finding. Additionally, the consolidation in the CXR was primarily distributed in the perihilar and paracardial regions (63.3%), followed by diffuse (12.2%). This finding was more common bilaterally (33 of 49, 67.3%) but in cases of unilaterality, the right lung was more common (14 of 49, 28.6%). Bronchopneumonia was the most common parenchymal lesion found in 49 patients (94.2%). Given RT-PCR as the gold standard for COVID-19 diagnosis, the CXR sensitivity in our study is 38.5% (95% confidence interval, 30.3%–47.3%). Of the 135 RT-PCR-confirmed COVID-19 paediatric patients, 52 had abnormal CXR findings suggestive of COVID-19. Most cases were mild, and the most frequent symptoms were fever (80.7%), cough (63%), coryza (35.6%), and diarrhoea (16.3%). Boys were 75 cases (55.6%), and 39.3% of subjects were above ten years old. The mean age of our study sample was 96.7 months old. This study was approved by the Health Research Ethical Committee of Universitas Sumatera Utara (No.162/KEP/USU/2020). Chi-square or Fisher exact test analysis was used to compare categorical data, and a P value of <0.05 was considered statistically significant. The crosstab option in SPSS was used to calculate the PR estimate and confidence intervals. The strength of association between a predictor variable and an outcome variable (CXR findings) is measured using prevalence ratio (PR), that is, the ratio between the prevalence of outcome (abnormal CXR) among those with the factors divided by the prevalence rate among those without the factor. Numeric variables are presented as arithmetic means and categoric variables as frequencies and percentages. Comorbidity was defined as any additional condition that has existed or may occur during the clinical course under study and might affect the disease course or outcome. The COVID-19 severity classification was as per national guidelines. Patient data such as age, sex, presenting symptoms, comorbidity, and outcome were also extracted. A board-certified radiologist in each hospital analysed CXR readings, and the parameters evaluated were: (a) whether it is normal or abnormal, (b) the affected lung side (unilateral or bilateral), and (c) the radiological findings. Anteroposterior or posteroanterior positions of the paediatric CXR examination were performed at radiation doses suitable for children. In total, 135 of 231 children were included in this analysis. The inclusion criteria were children aged less than 18 years with COVID-19 infection confirmed by RT-PCR from April 1, 2020, to March 31, 2021. Medical records of hospitalised children with COVID-19 in 3 main COVID-19 referral hospitals in Medan City, North Sumatera, were reviewed.
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