INTRODUCTION
Community-acquired pneumonia (CAP) is one of the most frequent infectious diseases in children, leading to widespread antibiotic use and hospitalization. While CAP is often multifactorial, viruses, including respiratory syncytial virus (RSV), human metapneumovirus (hMPV), influenza, parainfluenza virus (PIV), rhinovirus (RhV) and adenovirus (ADV), are considered as the main causative agents of pediatric CAP worldwide, with a reported rate of 25% to 82%1–4.
Like other viruses of the coronavirus family, SARS-CoV-2 causes a spectrum of clinical manifestations grouped under the term coronavirus disease 2019 (COVID-19), and patients often present with respiratory conditions of different severity, including CAP. Children usually have a less severe COVID-19 infection than adults2-9, and <15% require hospitalization5–8. Among hospitalized children, however, the most frequent diagnosis is CAP.
We recently showed that COVID-19 positivity by real-time PCR (RT-PCR) in children can persist for up to three months9. Accordingly, a positive PCR in a child with non-SARS-CoV-2 viral CAP can be misdiagnosed as COVID-19. It remains unclear whether SARS-CoV-2-associated CAP can be differentiated from other viral CAP-related infections based on clinical, analytical or radiographical findings. In addition, in children with CAP and coinfections with SARS-CoV-2 and other viruses, it is difficult to distinguish which virus contributes most to the CAP10.
The present study sought to determine the characteristics of children admitted due to SARS-CoV-2-associated CAP and to compare these findings with those of children with other viral-associated CAP.