Comparison between SARS-CoV-2 positive and negative pneumonia in children: A retrospective analysis at the beginning of the pandemic

Abstract

BACKGROUND Even though coronavirus 2019 disease (COVID-19) clinical course in children is much milder than in adults, pneumonia can occur in the pediatric population as well. Here, we reported a single-center pediatric case series of COVID-19 from Kazakhstan during the first wave of pandemic. AIM To analyze the main clinical and laboratory aspects in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) positive and negative children diagnosed with pneumonia. METHODS This is a retrospective analysis of 54 children, who were medically assessed as close contacts of COVID-19 adults in their family setting, between June and September 2020. These children were all hospitalized: We compared the clinical and laboratory characteristics of children affected with pneumonia in the presence (group 1) or absence (group 2) of SARS-CoV-2 infection. RESULTS Overall, the main clinical manifestations at the admission were fever, cough, loss of appetite, fatigue/weakness, nasal congestion and/or rhinorrhea, and dyspnea. Based on the SARS-CoV-2 polymerase chain reaction (PCR) test, 24 positive children with pneumonia (group 1) and 20 negative children with pneumonia (group 2) were identified; 10 positive children did not show any radiological findings of pneumonia. No significant differences were found between the two pneumonia study groups for any clinical and laboratory parameters, except for C-reactive protein (CRP). Of course, both pneumonia groups showed increased CRP values; however, the COVID-19 pneumonia group 1 showed a significantly higher increase of CRP compared to group 2. CONCLUSION In our case series of children assessed for SARS-CoV-2 infection based on contact tracing, the acute inflammatory response and, in detail, CRP increase resulted to be more pronounced in COVID-19 children with pneumonia than in children with SARS-CoV-2-unrelated pneumonia. However, because of multiple limitations of this study, larger, controlled and more complete clinical studies are needed to verify this finding.

“Lymphocyte * Neutrophil” count decreased in SARS‐CoV‐2 Omicron patients in Shanghai with no significant change in CRP and SAA

“…6 CRP has been suggested to be associated with respiratory function (PaO 2 /FiO 2 ), is a predictor of respiratory failure 24 , and it's elevation is widely used as an inflammatory factor in SARS-CoV-2 infection. [25][26][27] In our study, we found that CNR was increased compared with the negative group, and the difference was statistically significant (p < 0.05).…”

“…CAR (C‐reactive protein to serum albumin ratio) has high sensitivity and specificity in the diagnosis of diabetes nephropathy 6 . CRP has been suggested to be associated with respiratory function (PaO 2 /FiO 2 ), is a predictor of respiratory failure 24 , and it's elevation is widely used as an inflammatory factor in SARS‐CoV‐2 infection 25–27 …”

Which Groups of Children Are at More Risk of Fatality during COVID-19 Pandemic? A Case-Control Study in Yazd, Iran

“…Our study confrmed that dyspnea on admission time was strongly correlated with mortality, consistent with a study conducted in Vietnam [27]. Fever was the most prevalent symptom observed in both the deceased and survived groups, followed by vomiting and dyspnea in the deceased group, and cough in the survived group, aligning with previous research [28][29][30][31][32][33][34]. Notably, despite the high frequency of fever and vomiting among the deceased group, there was no statistically signifcant increase in the risk of death, which corresponds with fndings from a study conducted in Brazil [35].…”

Evaluation of the Characteristics of Respiratory Viruses and Coinfections in Hospitalized Children during the COVID-19 Pandemic

“…[33][34][35][36] In a study on COVID-19 pneumonia and other viral agents, no statistical difference was found between hematological parameters, similar to our study. 37 However, studies investigating MLR, PLR, and SII in respiratory tract viral infections other than COVID-19 could not be found in the literature.…”