Comparison between SARS-CoV-2 positive and negative pneumonia in children: A retrospective analysis at the beginning of the pandemic

Adil Zhamankulov; Rafail Rozenson; Marina Morenko; Ulzhan Akhmetova; Alina Tyo; Dimitri Poddighe

doi:10.5493/wjem.v12.i2.26

Comparison between SARS-CoV-2 positive and negative pneumonia in children: A retrospective analysis at the beginning of the pandemic

World J Exp Med. 2022 Mar 20;12(2):26-35. doi: 10.5493/wjem.v12.i2.26.

Authors

Adil Zhamankulov¹, Rafail Rozenson¹, Marina Morenko¹, Ulzhan Akhmetova¹, Alina Tyo¹, Dimitri Poddighe²

Affiliations

¹ Department of Children's diseases, Astana Medical University, First Children's Municipal Hospital, Nur-Sultan 010000, Kazakhstan.
² Clinical Academic Department of Pediatrics, National Research Center for Maternal and Child Health, University Medical Center, Nur-Sultan 010000, Kazakhstan. dimitri.poddighe@nu.edu.kz.

Abstract

Background: Even though coronavirus 2019 disease (COVID-19) clinical course in children is much milder than in adults, pneumonia can occur in the pediatric population as well. Here, we reported a single-center pediatric case series of COVID-19 from Kazakhstan during the first wave of pandemic.

Aim: To analyze the main clinical and laboratory aspects in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) positive and negative children diagnosed with pneumonia.

Methods: This is a retrospective analysis of 54 children, who were medically assessed as close contacts of COVID-19 adults in their family setting, between June and September 2020. These children were all hospitalized: We compared the clinical and laboratory characteristics of children affected with pneumonia in the presence (group 1) or absence (group 2) of SARS-CoV-2 infection.

Results: Overall, the main clinical manifestations at the admission were fever, cough, loss of appetite, fatigue/weakness, nasal congestion and/or rhinorrhea, and dyspnea. Based on the SARS-CoV-2 polymerase chain reaction (PCR) test, 24 positive children with pneumonia (group 1) and 20 negative children with pneumonia (group 2) were identified; 10 positive children did not show any radiological findings of pneumonia. No significant differences were found between the two pneumonia study groups for any clinical and laboratory parameters, except for C-reactive protein (CRP). Of course, both pneumonia groups showed increased CRP values; however, the COVID-19 pneumonia group 1 showed a significantly higher increase of CRP compared to group 2.

Conclusion: In our case series of children assessed for SARS-CoV-2 infection based on contact tracing, the acute inflammatory response and, in detail, CRP increase resulted to be more pronounced in COVID-19 children with pneumonia than in children with SARS-CoV-2-unrelated pneumonia. However, because of multiple limitations of this study, larger, controlled and more complete clinical studies are needed to verify this finding.

Keywords: C-reactive protein; Chest X-ray; Inflammatory parameters; Pediatric COVID-19; Pneumonia; SARS-CoV-2.