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In Frontiers in cellular and infection microbiology ; h5-index 53.0

Background : The pandemic of Coronavirus Disease 2019 (COVID-19) brings new challenges for pediatricians, especially in the differentiation with non-COVID-19 pneumonia in the peak season of pneumonia. We aimed to compare the clinical characteristics of pediatric patients with COVID-19 and other respiratory pathogens infected pneumonias.

Methods : We conducted a multi-center, cross-sectional study of pediatric inpatients in China. Based on pathogenic test results, pediatric patients were divided into three groups, including COVID-19 pneumonia group, Non-COVID-19 viral (NCV) pneumonia group and Non-viral (NV) pneumonia group. Their clinical characteristics were compared by Kruskal-Wallis H test or chi-square test.

Results : A total of 636 pediatric pneumonia inpatients, among which 87 in COVID-19 group, 194 in NCV group, and 355 in NV group, were included in analysis. Compared with NCV and NV patients, COVID-19 patients were older (median age 6.33, IQR 2.00-12.00 years), and relatively fewer COVID-19 patients presented fever (63.2%), cough (60.9%), shortness of breath (1.1%), and abnormal pulmonary auscultation (18.4%). The results were verified by the comparison of COVID-19, respiratory syncytial virus (RSV) and influenza A (IFA) pneumonia patients. Approximately 42.5%, 44.8%, and 12.6% of the COVID-19 patients presented simply ground-glass opacity (GGO), simply consolidation, and the both changes on computed tomography (CT) scans, respectively; the proportions were similar as those in NCV and NV group (p>0.05). Only 47.1% of COVID-19 patients had both lungs pneumonia, which was significantly lower than that proportion of nearly 80% in the other two groups. COVID-19 patients presented lower proportions of increased white blood cell count (16.5%) and abnormal procalcitonin (PCT) (10.7%), and a higher proportion of decreased lymphocyte count (44.0%) compared with the other two groups.

Conclusion : Majority clinical characteristics of pediatric COVID-19 pneumonia patients were milder than non-COVID-19 patients. However, lymphocytopenia remained a prominent feature of COVID-19 pediatric pneumonia.

Jia Zhongwei, Yan Xiangyu, Gao Liwei, Ding Shenggang, Bai Yan, Zheng Yuejie, Cui Yuxia, Wang Xianfeng, Li Jingfeng, Lu Gen, Xu Yi, Zhang Xiangyu, Li Junhua, Chen Ning, Shang Yunxiao, Han Mingfeng, Liu Jun, Zhou Hourong, Li Cen, Lu Wanqiu, Liu Jun, Wang Lina, Fan Qihong, Wu Jiang, Shen Hanling, Jiao Rong, Chen Chunxi, Gao Xiaoling, Tian Maoqiang, Lu Wei, Yang Yonghong, Wong Gary Wing-Kin, Wang Tianyou, Jin Runming, Shen Adong, Xu Baoping, Shen Kunling

2021

COVID-19 pneumonia, clinical characteristics, non-viral pneumonia, pediatric patients, viral pneumonia