Comparison of Severe Viral Pneumonia Caused by SARS-CoV-2 and Other Respiratory Viruses Among Malaysian Children During the COVID-19 Pandemic

David Chun-Ern Ng; Kah Kee Tan; Grace Sieng Sing Ting; Chin Ling; Nur Fadzreena Binti Fadzilah; Shir Fong Tan; Thayasheri Subramaniam; Nur Emylia Binti Zailanalhuddin; Hui Yi Lim; Suhaila Binti Baharuddin; Yee Lean Lee; Airena Mohamad Nor; Erwin Jiayuan Khoo

doi:10.3389/fped.2022.865099

Comparison of Severe Viral Pneumonia Caused by SARS-CoV-2 and Other Respiratory Viruses Among Malaysian Children During the COVID-19 Pandemic

Front Pediatr. 2022 Apr 25:10:865099. doi: 10.3389/fped.2022.865099. eCollection 2022.

Affiliations

¹ Department of Pediatrics, Hospital Tuanku Ja'afar Seremban, Seremban, Malaysia.
² Department of Pediatrics, Perdana University-Royal College of Surgeons in Ireland School of Medicine, Seremban, Malaysia.
³ Microbiology Unit, Department of Pathology, Hospital Tuanku Ja'afar Seremban, Seremban, Malaysia.
⁴ Department of Pediatrics, International Medical University, Seremban, Malaysia.

Abstract

Objectives: We described the etiology of severe pneumonia in children during the height of the COVID-19 pandemic in Malaysia and compared the clinical features of severe SARS-CoV-2 to other respiratory viruses.

Methods: This retrospective study included all children aged 12 years and below hospitalized with severe pneumonia in Negeri Sembilan, Malaysia, between 1 April 2021 and 31 October 2021. We extracted demographic and clinical data and used logistic regression to examine risk factors associated with severe SARS-CoV-2 or other viral pneumonia.

Results: A total of 111 children were included. The median age was 15 months. Human rhinovirus/enterovirus, SARS-CoV-2 and respiratory syncytial virus were the most common etiology of severe pneumonia. Codetection of >1 viral pathogen was present in 14 (12.6%) patients. Children with severe COVID-19 presented early in the course of illness and had lower rates of pediatric intensive care admission. The presence of sick contact with an adult was a predictor for SARS-CoV-2, whereas adventitious breath sounds were predictive of other respiratory viruses.

Conclusions: The etiology of severe pneumonia in children evolved with the epidemic curve of COVID-19 and school closures. Children with severe pneumonia due to SARS-CoV-2 experienced a milder clinical course when compared to other respiratory viruses.

Keywords: COVID-19; SARS-CoV-2; children; severe pneumonia; viral pneumonia.