Comparison of Acute Pneumonia Caused by SARS-COV-2 and Other Respiratory Viruses in Children: A Retrospective Multi-Centered Cohort Study During COVID-19 Outbreak
Background Coronavirus disease-2019 (COVID-19) has got more than 12 million infections and causing a certain degree of panic. We conducted this study to describe the clinical manifestations, treatment and outcome of COVID-19 in children, as compared to other viral pneumonia diagnosed during COVID-19 outbreak.
Methods Children with COVID-19 and viral pneumonia of 20 hospitals were enrolled in this retrospective multi-centered cohort study. 64 children with COVID-19 were defined as the COVID-19 cohort, of which 40 cases developed to pneumonia were defined as the COVID-19 pneumonia cohort, while 284 pneumonia cases caused by other viruses were defined as the viral pneumonia cohort.
Results Compared to the viral pneumonia cohort, children in the COVID-19 cohort were mostly exposed to confirmed family members (53/64 vs 23/284), with older median age (6.3 vs 3.2 yr), and shown higher proportion of ground-glass opacity (GGO) on computed tomography (18/40 vs 0/38), all P<0.001. Children in the COVID-19 pneumonia cohort had lower proportion of severe cases (1/40 vs 38/284, P=0.048), cases with high fever (3/40 vs 167/284, P<0.001), cases required intensive care (1/40 vs32/284, P<0.047) and the symptomatic duration was shorter (median 5 vs 8 days, P<0.001). The proportion of cases with evaluated inflammatory indicators, biochemical indicators related to organ or tissue damage, D-dimer and secondary infection with bacteria were lower in the COVID-19 pneumonia cohort than that of viral pneumonia cohort (all P<0.05). There was no statistic difference in the duration of positive PCR results from pharyngeal swabs when antiviral drugs (Lopinavir-ritonavir, ribavirin, and arbidol) were used in 25 children with COVID-19 as compared to 39 cases without antiviral therapy [median 10 vs 9 days, P=0.885].
Conclusions The symptoms and severity of COVID-19 pneumonia in children were no more severe than those of other viral pneumonia. Lopinavir-ritonavir, ribavirin and arbidol cannot shorten the duration of positive PCR results from pharyngeal swabs in children with COVID-19 in this study. Children with other pathogens infection should be paid attention to even though the COVID-19 outbreak.
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On 16 Feb, 2021
On 03 Feb, 2021
Received 27 Sep, 2020
Invitations sent on 26 Sep, 2020
On 26 Sep, 2020
On 22 Sep, 2020
On 21 Sep, 2020
On 21 Sep, 2020
Posted 20 Jul, 2020
On 13 Aug, 2020
Received 11 Aug, 2020
On 30 Jul, 2020
Received 27 Jul, 2020
Invitations sent on 26 Jul, 2020
On 26 Jul, 2020
On 26 Jul, 2020
On 26 Jul, 2020
Received 26 Jul, 2020
Received 26 Jul, 2020
On 16 Jul, 2020
On 15 Jul, 2020
On 15 Jul, 2020
On 15 Jul, 2020
Comparison of Acute Pneumonia Caused by SARS-COV-2 and Other Respiratory Viruses in Children: A Retrospective Multi-Centered Cohort Study During COVID-19 Outbreak
On 16 Feb, 2021
On 03 Feb, 2021
Received 27 Sep, 2020
Invitations sent on 26 Sep, 2020
On 26 Sep, 2020
On 22 Sep, 2020
On 21 Sep, 2020
On 21 Sep, 2020
Posted 20 Jul, 2020
On 13 Aug, 2020
Received 11 Aug, 2020
On 30 Jul, 2020
Received 27 Jul, 2020
Invitations sent on 26 Jul, 2020
On 26 Jul, 2020
On 26 Jul, 2020
On 26 Jul, 2020
Received 26 Jul, 2020
Received 26 Jul, 2020
On 16 Jul, 2020
On 15 Jul, 2020
On 15 Jul, 2020
On 15 Jul, 2020
Background Coronavirus disease-2019 (COVID-19) has got more than 12 million infections and causing a certain degree of panic. We conducted this study to describe the clinical manifestations, treatment and outcome of COVID-19 in children, as compared to other viral pneumonia diagnosed during COVID-19 outbreak.
Methods Children with COVID-19 and viral pneumonia of 20 hospitals were enrolled in this retrospective multi-centered cohort study. 64 children with COVID-19 were defined as the COVID-19 cohort, of which 40 cases developed to pneumonia were defined as the COVID-19 pneumonia cohort, while 284 pneumonia cases caused by other viruses were defined as the viral pneumonia cohort.
Results Compared to the viral pneumonia cohort, children in the COVID-19 cohort were mostly exposed to confirmed family members (53/64 vs 23/284), with older median age (6.3 vs 3.2 yr), and shown higher proportion of ground-glass opacity (GGO) on computed tomography (18/40 vs 0/38), all P<0.001. Children in the COVID-19 pneumonia cohort had lower proportion of severe cases (1/40 vs 38/284, P=0.048), cases with high fever (3/40 vs 167/284, P<0.001), cases required intensive care (1/40 vs32/284, P<0.047) and the symptomatic duration was shorter (median 5 vs 8 days, P<0.001). The proportion of cases with evaluated inflammatory indicators, biochemical indicators related to organ or tissue damage, D-dimer and secondary infection with bacteria were lower in the COVID-19 pneumonia cohort than that of viral pneumonia cohort (all P<0.05). There was no statistic difference in the duration of positive PCR results from pharyngeal swabs when antiviral drugs (Lopinavir-ritonavir, ribavirin, and arbidol) were used in 25 children with COVID-19 as compared to 39 cases without antiviral therapy [median 10 vs 9 days, P=0.885].
Conclusions The symptoms and severity of COVID-19 pneumonia in children were no more severe than those of other viral pneumonia. Lopinavir-ritonavir, ribavirin and arbidol cannot shorten the duration of positive PCR results from pharyngeal swabs in children with COVID-19 in this study. Children with other pathogens infection should be paid attention to even though the COVID-19 outbreak.
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Figure 2
Figure 3