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

Abstract

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.