Clinical features and outcomes of patients with
SARS-CoV-2-associated pneumonia.
Demographic, clinical, analytical, and radiological characteristics are
shown in Table 1. Almost half (72/151, 48%) of all children in our
series had underlying conditions, including: asthma, 29/144 (20%);
immunosuppressive treatment, 22/151 (14%); chronic lung disease, 16/151
(11%); or heart disease, 15/151 (10%). Most children had fever 115/151
(76%) or cough 117/151 (77%) at admission, and 63/151 (42%) had
dyspnea or work of breathing. Other features included rhinorrhea 61/151
(40%) or fatigue 40/151 (26%), and only 5/151 children (3%) had
anosmia or dysgeusia. Of the 151 patients, 22 (15%) required admission
to a PICU, during a median of 5 days (IQR 1–15). Most children
(146/151, 97%) had a favorable clinical course and were discharged
after improvement. However, 5/151 (3%) children died, and all had
serious comorbidities: 3 had chronic lung disease (bronchopulmonary
dysplasia, idiopathic interstitial pneumonia or pulmonary pathology due
to spinal muscular atrophy), and 2 had immunosuppression due to
hematological disease and bone marrow transplant.
Radiology and laboratory findings .
For the diagnosis of pneumonia, all patients underwent at least one
chest X-ray. Upon admission, 151 patients presented with initial CXR
alterations, with 64/151 (42%) presenting with consolidation and 87/151
(58%) showing other infiltrates, according to WHO classification. Only
a few patients (6/151, 4%) presented with pleural effusion and in 4 of
them (67%) thoracentesis was performed. Coinfection was demonstrated in
only 5/151 (3%) cases: two cases of Staphylococcus aureus , one
of S.pneumoniae (pneumococcal antigen in pleural fluid), and two
due to rhinovirus and influenza virus (1/151, 0.6% each).
Full blood count (FBC) analysis revealed leukopenia (<5 ×
109/L) in 41/142 (29%) cases, lymphocytopenia
(<1.5 × 109/L) in 59/142 (42%),
thrombocytopenia (<150 × 109/L) in 22/142
(15%) and anemia (hemoglobin <11.5 g/L) in 54/142 (38%)
cases. Regarding inflammatory markers, CRP levels >20 mg/L
were reported in 65/135 (48%) patients, and procalcitonin levels
>0.5 ng/ml in 26/102 (25%), with 12/102 (12%) of the
patients having levels >2 ng/ml. Regarding blood
coagulation function, the D-dimer median was 699.5 µg/L (IQR
160.5–3402) and was increased in 62/96 (65%) of the patients. Other
findings are shown in Table 1.