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.