Chest radiological features and their association with clinical manifestations in COVID-19 positive neonates and young infants

We report the Radiological findings in relation to the clinical features of coronavirus disease (COVID-19) in 37 symptomatic neonates and young infants (<2 months of age) who presented with a sepsis-like picture and proved to be infected with COVID-19. 
Patients and methods: We reviewed, recorded, and analyzed the clinical findings in relation to the imaging features of coronavirus disease (COVID-19) in 37 symptomatic neonates and young infants (<2 months of age) who presented with sepsis-like picture (fever, hypotonia, hypoactivity, cough, and poor feeding) and proved to be infected with COVID19 (PCR) between January 1, 2020, and June 1, 2020.
Results: Our symptomatic newborns with COVID-19 infection had increased pulmonary vascularity in 6.2%, slightly accentuated central lung vascularity in 12.5%, and prominent hilar shadows with increased linear lung shadowing in the perihilar and precardiac in 34%. Increased linear lung shadowing with a tiny beaded-like appearance more distributed peripherally and at lower lobes occurred in 28%. Superadded peri-bronchial cuffing and perivascular haziness and lace-like fine linear appearance of interstitium occurred in 9.3%. Ground glass fine opacities (GGO) scattered in two or more lobes of both lungs appeared in 15.6%. Only 6.2% of symptomatic newborns showed superadded consolidations in both lungs, mainly peripherally oriented. Correlation with clinical severity of the disease (requirement of oxygen and assisted ventilation) proved that the appearance of GGO without consolidations was associated with moderate clinical severity, while the appearance of consolidations was associated with marked disease severity.
Conclusions: These findings brought more attention and understanding of the radiological manifestations and their association with the clinical severity in COVID19 positive newborns and young infants.