Acknowledgements
We thank all the patients and families for their participation in the
study, and the laboratory and clinical staff members who cared for them.
We thank Dr. Kenneth McCreath (Universidad Europea de Madrid) for
editorial assistance.
ABSTRACTPneumonia is a frequent manifestation of COVID-19 in hospitalized
children. Methods The study involved 80 hospitals in the SARS-CoV-2 Spanish Pediatric
National Cohort. Participants were children <18 years,
hospitalized with SARS-CoV-2 community-acquired pneumonia (CAP). We
compared the clinical characteristics of SARS-CoV-2-associated CAP with
CAP due to other viral etiologies from 2012 to 2019.
Results In total, 151 children with SARS-CoV-2-associated CAP and 138 with
other viral CAP included. Main clinical features of
SARS-CoV-2-associated CAP were cough 117/151(77%), fever 115/151(76%)
and dyspnea 63/151(46%); 22/151(15%) patients were admitted to a
pediatric intensive care unit (PICU), and 5/151(3%) patients died.
Lymphopenia was found in 63/147(43%) patients. Chest X-ray revealed
condensation (64/151[42%]) and other infiltrates
(87/151[58%]). Compared with CAP from other viral pathogens,
COVID-19 patients were older (8 vs.1 year; odds ratio [OR] 1.42
[95% confidence interval, CI 1.23;1.42]), with lower CRP levels (23
vs.48 mg/L; OR 1 [95%CI 0.99;1]), less wheezing (17 vs.53%; OR
0.18 [95%CI 0.11;0.31]) and greater need of mechanical ventilation,
MV (7 vs.0.7%, OR 10.8 [95%CI 1.3;85). Patients with
non-SARS-CoV-2-associated CAP had a greater need for oxygen therapy (77
vs.44%, OR 0.24 [95%CI 0.14;0.40]). There were no differences in
the use of CPAP or HVF or PICU admission between groups.
Conclusion SARS-CoV-2-associated CAP in children presents differently to other
virus-associated CAP: children are older and rarely have wheezing or
high CRP levels; they need less oxygen but more CPAP or MV. However,
several features overlap, and differentiating the etiology may be
difficult. The overall prognosis is good.