Pneumonia in Hospitalized Children During COVID-19 Pandemic. Characterization of SARS-COV2 Pneumonia. Multi-Center Cohort Study

Author(s): Hassan M Al-AsY, Osama Toema, Omar Hasanin, Maali Mabrouk, Manal Eldiba, Mohamed Hamza

Introduction and objectives: Although COVID-19 is milder in young than adults. However, it can cause pneumonia in children eventually requiring hospitalization. Clinical similarity between COVID-19, other viral, and bacterial pneumonia at initial presentation of the disease caused a great challenge. We aimed to differentiate COVID-19 pneumonia from other viral and bacterial pneumonia in children, and to characterize it.

Materials and Methods: This study included 300 children, who were hospitalized with clinically and radiologically confirmed pneumonia during COVID-19 pandemic. Clinical symptoms were collected and analyzed. Cultures, real time polymerase chain transcriptase test for some respiratory viruses and SARS-COV2, C-reactive protein, serum procalcitonin, serum ferritin, complete blood counts, and ferritin/procalcitonin ratio were done for all patients.

Results: This study showed that COVID-19 pneumonia was only 15 % of all admitted pneumonia cases. It had low proportion of high fever, mild course, significant lymphopenia, significant thrombocytopenia, low procalcitonin, low C-reactive protein, higher ferritin/procalcitonin ratio, and higher neutrophil/lymphocyte ratio, significant high percentage of ground glass, and less percentage of consolidation in CT images.

Conclusion: During (COVID-19) outbreak characterization of COVID-19 pneumonia and taking naso- pharyngeal swabs for multi-respiratory pathogen, including SARS-COV-2, help not to attribute pneumonia due to other causes to be due to COVID-19. Pneumonia due to COVID-19 is less common, and less severe than that caused by other viruses or bacteria in children. However, further large-sample studies are needed to have full blown picture about COVID-19 pneumonia in children.