Comparison of acute pneumonia caused by SARS-CoV-2 and other respiratory viruses in children: a retrospective multi-center cohort study during COVID-19 outbreak

Guang-Li Ren; Xian-Feng Wang; Jun Xu; Jun Li; Qiong Meng; Guo-Qiang Xie; Bo Huang; Wei-Chun Zhu; Jing Lin; Cheng-He Tang; Sheng Ye; Zhuo Li; Jie Zhu; Zhen Tang; Ming-Xin Ma; Cong Xie; Ying-Wen Wu; Chen-Xi Liu; Fang Yang; Yu-Zong Zhou; Ying Zheng; Shu-Ling Lan; Jian-Feng Chen; Feng Ye; Yu He; Ben-Qing Wu; Long Chen; Si-Mao Fu; Cheng-Zhong Zheng; Yuan Shi

doi:10.1186/s40779-021-00306-7

Your Location：

Home >

Browse articles >

Comparison of acute pneumonia caused by SARS-CoV-2 and other respiratory viruses in children: a retrospective multi-center cohort study during COVID-19 outbreak

RESEARCH | Updated：2023-02-28

- Comparison of acute pneumonia caused by SARS-CoV-2 and other respiratory viruses in children: a retrospective multi-center cohort study during COVID-19 outbreak
- Military Medical Research Vol. 8, Issue 4, Pages: 468-480(2021)
- Affiliations：
  
  1.Department of Pediatrics, General Hospital of Southern Theater Command of PLA, 111 Liuhua Road, Yuexiu District, Guangzhou 510010, Guangdong, China
  2.Department of Pediatrics, the Third People’s Hospital of Shenzhen, Shenzhen 518100, Guangdong, China
  3.Pediatric Intensive Care Unit, Wuhan Children’s Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430010, China
  4.Pediatric Intensive Care Unit, Maternal and Child Health Hospital of Huangshi, Huangshi 435000, Hubei, China
  5.Department of Pediatrics, the Second People’s Hospital of Guangdong Province, Guangzhou 510317, China
  6.Department of Pediatrics, the Third Affiliated Hospital of Zunyi Medical University (the First People’s Hospital of Zunyi), Guizhou 563000, China
  7.Department of Pediatrics, the Eighth People’s Hospital of Guangzhou, Guangzhou 510440, China
  8.Department of Pediatrics, the First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453100, Henan, China
  9.Pediatric Intensive Care Unit, the Children’s Hospital Zhejiang University School of Medicine, Hangzhou 310000, China
  10.Department of Emergency / Critical Medicine, Children’s Hospital of Nanjing Medical University, Nanjing 210008, China
  11.Department of Pediatrics, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China
  12.Department of Medical information date room, General Hospital of Southern Theater Command of PLA, Guangzhou 510010, China
  13.Department of Pediatrics, the First Affiliated Hospital of Jinan University, Guangzhou 510632, China
  14.Department of Pediatrics, Maternal and Child Health Hospital of Yangjiang, Yangjiang 529500, Guangdong, China
  15.Department of Pediatrics, Shenzhen Hospital Affiliated to the University of Chinese Academy of Sciences, Shenzhen 518107, Guangdong, China
  16.Department of Pediatrics, Nanfang Hospital of Southern Medical University, Guangzhou 510515, China
  17.Department of Pediatrics, Zhujiang Hospital of Southern Medical University, Guangzhou 510280, China
  18.Department of Pediatrics, Military Hospital of 74 Group of PLA, Guangzhou 510318, China
  19.Department of Neonatology, Children’s Hospital of Chongqing Medical University/Ministry of Education Key Laboratory of Child/Development and Disorders/National Clinical Research Center for Child Health and Disorders/Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
  20.Department of Pediatrics, Zhongshan Boai Hospital, Zhongshan 528403, Guangdong, China
  21.Department of Pediatrics, Strategic Support Force Medical Center of PLA, Beijing 100101, China
- Author bio：
  
  * guangliren@hotmail.com;
  zs5319753@163.com;
  zcz3066@126.com;
  petshi530@vip.163.com
- Funds：
- DOI：10.1186/s40779-021-00306-7
  CLC：
- Published：2021-12
- Accepted：
Scan QR Code
Ren et al.: Comparison of acute pneumonia caused by SARS-CoV-2 and other respiratory viruses in children: a retrospective multi-center cohort study during COVID-19 outbreak. Mil Med Res, 2021, 8: 13.
DOI：

Ren et al.: Comparison of acute pneumonia caused by SARS-CoV-2 and other respiratory viruses in children: a retrospective multi-center cohort study during COVID-19 outbreak. Mil Med Res, 2021, 8: 13. DOI： 10.1186/s40779-021-00306-7.

摘要

Abstract

Background:

Until January 18

2021

coronavirus disease-2019 (COVID-19) has infected more than 93 million individuals and has caused a certain degree of panic. Viral pneumonia caused by common viruses such as respiratory syncytial virus

rhinovirus

human metapneumovirus

human bocavirus

and parainfluenza viruses have been more common in children. However

the incidence of COVID-19 in children was significantly lower than that in adults. The purpose of this study was to describe the clinical manifestations

treatment and outcomes of COVID-19 in children compared with those of other sources of viral pneumonia diagnosed during the COVID-19 outbreak.

Methods:

Children with COVID-19 and viral pneumonia admitted to 20 hospitals were enrolled in this retrospective multi-center cohort study. A total of 64 children with COVID-19 were defined as the COVID-19 cohort

of which 40 children who developed pneumonia were defined as the COVID-19 pneumonia cohort. Another 284 children with pneumonia caused by other viruses were defined as the viral pneumonia cohort. The epidemiologic

clinical

and laboratory findings were compared by Kolmogorov-Smirnov test

-test

Mann-Whitney

test and Contingency table method. Drug usage

immunotherapy

blood transfusion

and need for oxygen support were collected as the treatment indexes. Mortality

intensive care needs and symptomatic duration were collected as the outcome indicators.

Results:

Compared with the viral pneumonia cohort

children in the COVID-19 cohort were mostly exposed to family members confirmed to have COVID-19 (53/64

. 23/284)

were of older median age (6.3 years

. 3.2 years)

and had a higher proportion of ground-glass opacity (GGO) on computed tomography (18/40

. 0/38

0.001). Children in the COVID-19 pneumonia cohort had a lower proportion of severe cases (1/40

. 38/284

=0.048)

and lower cases with high fever (3/40

. 167/284

0.001)

requiring intensive care (1/40

. 32/284

0.047) and with shorter symptomatic duration (median 5 d

. 8 d

0.001). The proportion of cases with evaluated inflammatory indicators

biochemical indicators related to organ or tissue damage

D-dimer and secondary bacterial infection were lower in the COVID-19 pneumonia cohort than those in the viral pneumonia cohort (

0.05). No statistical differences were found in the duration of positive PCR results from pharyngeal swabs in 25 children with COVID-19 who received antiviral drugs (lopinavir-ritonavir

ribavirin

and arbidol) as compared with duration in 39 children without antiviral therapy (median 10 d

. 9 d

=0.885).

Conclusions:

The symptoms and severity of COVID-19 pneumonia in children were no more severe than those in children with other viral pneumonia. Lopinavir-ritonavir

ribavirin and arbidol do not shorten the duration of positive PCR results from pharyngeal swabs in children with COVID-19. During the COVID-19 outbreak

attention also must be given to children with infection by other pathogens infection.

关键词

Keywords

references

Chen Y , Liu Q , Guo D . Emerging coronaviruses: genome structure, replication, and pathogenesis . J Med Virol . 2020 ; 92 ( 4 ): 418 - 23 .

Donnelly CA , Ghani AC , Leung GM , Hedley AJ , Fraser C , Riley S , et al . Epidemiological determinants of spread of causal agent of severe acute respiratory syndrome in Hong Kong . Lancet . 2003 ; 361 ( 9371 ): 1761 - 6 .

Cauchemez S , Fraser C , Van Kerkhove MD , Donnelly CA , Riley S , Rambaut A , et al . Middle East respiratory syndrome coronavirus: quantification of the extent of the epidemic, surveillance biases, and transmissibility . Lancet Infect Dis . 2014 ; 14 ( 1 ): 50 - 6 .

Li Q , Guan XH , Wu P , Wang XY , Zhou L , Tong YQ , et al . Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia . N Engl J Med . 2020 ; 382 ( 13 ): 1199 - 207 .

Who . WHO coronavirus disease (COVID-19) dashboard . https://covid19.who.int/ https://covid19.who.int/ . Accessed 18 Jan 2021 .

Wu ZY , Mcgoogan JM . Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China summary of a report of 72 314 cases from the Chinese center for disease control and prevention . JAMA . 2020 ; 323 ( 13 ): 1239 - 42 .

Cai J , Xu J , Lin D , Yang Z , Xu L , Qu Z , et al . A case series of children with 2019 novel coronavirus infection: clinical and epidemiological features . Clin Infect Dis . 2020 ; 71 ( 6 ): 1547 - 51 . https://doi.org/10.1093/cid/ciaa198 https://doi.org/10.1093/cid/ciaa198 .

Qiu HY , Wu JH , Hong L , Luo YL , Song QF , Chen D . Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: an observational cohort study . Lancet Infect Dis . 2020 ; 20 ( 6 ): 689 - 96 .

Lu XX , Zhang LQ , Du H , Zhang JJ , Li YY , Qu JY , et al . SARS-CoV-2 infection in children . N Engl J Med . 2020 ; 382 ( 17 ): 1663 - 5 .

China National Health Commission . Diagnosis and treatment guidelines for 2019 novel coronavirus pneumonia (draft version 7) . 2020; http://www.nhc.gov.cn/yzygj/s7653p/202003/46c9294a7dfe4cef80dc7f5912eb1989.shtml http://www.nhc.gov.cn/yzygj/s7653p/202003/46c9294a7dfe4cef80dc7f5912eb1989.shtml .Accessed 8 May 2020 .

China National Health Commission . Guideline for diagnosis and treatment of community-acquired pneumonia in children (2019 version) . Chin J Clin Infect Dis . 2019 ; 12 ( 12 ): 6 - 13 .

Stockmann C , Ampofo K , Killpack J , Williams DJ , Edwards KM , Grijalva CG , et al . Procalcitonin accurately identifies hospitalized children with low risk of bacterial community-acquired pneumonia . J Pediatric Infect Dis Soc . 2018 ; 7 ( 1 ): 46 - 53 .

Wang DW , Hu B , Hu C , Zhu FF , Liu X , Zhang J , et al . Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China . JAMA . 2020 ; 323 ( 11 ): 1061 - 9 .

Xu X , Yu CC , Qu J , Zhang LG , Jiang SF , Huang DY , et al . Imaging and clinical features of patients with 2019 novel coronavirus SARS-CoV-2 . Eur J Nucl Med Mol Imaging . 2020 ; 47 ( 5 ): 1275 - 80 .

Babyn PS , Chu WCW , Tsou IYY , Wansaicheong GKL , Allen U , Bitnun A , et al . Severe acute respiratory syndrome (SARS): chest radiographic features in children . Pediatr Radiol . 2004 ; 34 ( 1 ): 47 - 58 .

Dong Y , Mo X , Hu Y , Qi X , Jiang F , Jiang Z , et al . Epidemiology of COVID-19 among children in China . Pediatrics . 2020 ; 145 ( 6 ): e20200702 . https://doi.org/10.1542/peds.2020-0702 https://doi.org/10.1542/peds.2020-0702 .

Guan WJ , Ni ZY , Hu Y , Liang WH , Ou CQ , He JX , et al . Clinical characteristics of coronavirus disease 2019 in China . N Engl J Med . 2020 ; 382 ( 18 ): 1708 - 20 .

Huang CL , Wang YM , Li XW , Ren LL , Zhao JP , Hu Y , et al . Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China . Lancet . 2020 ; 395 ( 10223 ): 497 - 506 .

Cao XT . COVID-19: immunopathology and its implications for therapy . Nat Rev Immunol . 2020 ; 20 ( 5 ): 269 - 70 .

Wong CK , Lam CWK , Wu AKL , Ip WK , Lee NLS , Chan IHS , et al . Plasma inflammatory cytokines and chemokines in severe acute respiratory syndrome . Clin Exp Immunol . 2004 ; 136 ( 1 ): 95 - 103 .

Falzarano D , De Wit E , Rasmussen AL , Feldmann F , Okumura A , Scott DP , et al . Treatment with interferon-alpha 2b and ribavirin improves outcome in MERS-CoV-infected rhesus macaques . Nat Med . 2013 ; 19 ( 10 ): 1313 - 7 .

Shen CF , Wang SM , Ho TS , Liu CC . Clinical features of community acquired adenovirus pneumonia during the 2011 community outbreak in southern Taiwan: role of host immune response . BMC Infect Dis . 2017 ; 17 ( 1 ): 196 . https://doi.org/10.1186/s12879-017-2272-5 https://doi.org/10.1186/s12879-017-2272-5 .

Mesev EV , Ledesma RA , Ploss A . Decoding type I and III interferon signalling during viral infection . Nat Microbiol . 2019 ; 4 ( 6 ): 914 - 24 .

Mehta P , Mcauley DF , Brown M , Sanchez E , Tattersall RS , Manson JJ , et al . COVID-19: consider cytokine storm syndromes and immunosuppression . Lancet . 2020 ; 395 ( 10229 ): 1033 - 4 .

Haq IJ , Battersby AC , Eastham K , Mckean M . Community acquired pneumonia in children . BMJ . 2017 ; 356 : j686 .

Views

Downloads

CSCD

Alert me when the article has been cited

Submit

Tools

Publicity Resources

Pattern of liver injury in adult patients with COVID-19: a retrospective analysis of 105 patients

Simulation Analysis of Girder Transport Process on the Box Girder of Hangzhou Bay Bridge

Dynamic Response Analysis of Tunnel Foundation by Vehicle Vibration in Metro

Experimental Research on the Maximum Tensile Force in Reinforced Abutment Reinforcement

Research on Synthetical 3 Factors Checking Method for the Ultimate Load Carrying Capacity of Steel Arch Bridges

Related Author

Qi Wang

Hong Zhao

Li-Gai Liu

Yan-Bin Wang

Ting Zhang

Ming-Hui Li

Yan-Li Xu

Gui-Ju Gao

Related Institution

Center of Liver Diseases, Beijing Ditan Hospital, Capital Medical University

Beijing Key Laboratory of Emerging Infectious Diseases

Clinical and Research Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University

Department of Critical Care Medicine, Beijing Ditan Hospital, Capital Medical University

⁰