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
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
- 解放军医学杂志（英文版） 2021年8卷第4期 页码：468-480
- 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：Scientific Research Project of Military Logistics Department(Grant Award Number: CLB20J032);The funders of this research had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript
DOI：10.1186/s40779-021-00306-7
中图分类号：-
纸质出版：2021-12
- Accepted：
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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[J]. 解放军医学杂志（英文版）, 2021,8(4):468-480.
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.
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[J]. 解放军医学杂志（英文版）, 2021,8(4):468-480. DOI： 10.1186/s40779-021-00306-7.
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:
2
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:
2
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
t
-test
Mann-Whitney
U
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:
2
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
vs
. 23/284)
were of older median age (6.3 years
vs
. 3.2 years)
and had a higher proportion of ground-glass opacity (GGO) on computed tomography (18/40
vs
. 0/38
P
<
0.001). Children in the COVID-19 pneumonia cohort had a lower proportion of severe cases (1/40
vs
. 38/284
P
=0.048)
and lower cases with high fever (3/40
vs
. 167/284
P
<
0.001)
requiring intensive care (1/40
vs
. 32/284
P
<
0.047) and with shorter symptomatic duration (median 5 d
vs
. 8 d
P
<
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 (
P
<
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
vs
. 9 d
P
=0.885).
Conclusions:
2
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
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