Low-field Magnetic Resonance Imaging of Pediatric COVID-19

SARS-CoV-2 (Severe acute respiratory syndrome coronavirus type 2) is a new coronavirus and
identified causative agent of COVID-19 disease. They predominantly cause mild colds, but can
sometimes cause severe pneumonia. While the molecular basis for the changes in lung tissue or
multi-organ involvement has been described, the age-specific long-term consequences,
especially in children and adolescents, are still largely unexplained and not understood.
Early publications from the primarily affected Chinese provinces described rather mild,
partly asymptomatic courses in children. This is consistent with the observation that the
risk of severe COVID-19 disease increases steeply from the age of 70 years, and is also
determined by the severity of obesity and other risk factors. Developmental expression of
tissue factors may be one reason for the relative protection of younger patients from severe
courses of the disease.

However, it is now becoming increasingly clear that some individuals with milder initial
symptoms of COVID-19 may suffer from variable and persistent symptoms for many months after
initial infection - this includes children. A modern low-field MRI is located in Erlangen,
Germany. This technique has already been used to demonstrate persistent damage to lung tissue
in adult patients after COVID-19. The device with a field strength of 0.55 Tesla (T)
currently has the world's largest bore (and is thus particularly suitable for patients with
claustrophobia, among other things), a very quiet operating noise, and lower energy
absorption in the tissue due to the weaker magnetic field than MRI scanners with 1.5T or 3T.
This allows MRI imaging in a very wide pediatric population without the need for sedation.

The purpose of this study is to assess the frequency of lung parenchymal changes using
low-field magnetic resonance imaging (LF-MRI) in pediatric and adolescent patients with past
SARS-CoV-2 infection detected by PCR.