Incidence, Clinical Features, and Factors Associated with Pediatric COVID-19 Pneumonia

Abstract

Background: In December 2019, the outbreak of SARS-CoV-2 infection was first reported in Wuhan, China. It rapidly spread worldwide, causing health, economic, and social problems. In terms of health issues, the critical condition is respiratory tract infection, especially pneumonia and subsequent respiratory failure. However, the incidence and related factors of COVID-19 pneumonia among children are still not well understood. Objective: To find the incidence and factors associated with pediatric COVID-19 pneumonia. Materials and Methods: A cross-sectional study was performed by including patients less than 15 years old whose nasopharyngeal PCR swabs were positive for COVID-19. All patients were admitted to the cohort ward or pediatric department at ChumPhae Hospital, Khon Kaen, Thailand between January 1 and December 31, 2021. Demographic data, clinical manifestations, laboratory data, and chest radiographs reported by radiologists were collected. Descriptive statistics was performed followed by simple and multiple logistic regressions to determine the associated factors of COVID-19 pneumonia. Results: Two hundred eighty-seven cases were included, with 114 cases or 39.7% (95% CI 34.1 to 45.7%) of abnormal chest radiographs reported. The risks associated with increasing pneumonia were weight-for-height percentage (adjusted OR 1.01, 95% CI 1 to 1.02). Aged younger than 1 year group and aged 1 to younger than 3 years old group had significantly higher risk of pneumonia than patients aged 7 to younger than 15 years old group [(adjusted OR 3.82, 95% CI 1.28 to 11.45) and (adjusted OR 5.7, 95% CI 2.62 to 12.43), respectively]. In contrast, rhinorrhea was slightly associated with lower risk (adjusted OR 0.51, 95% CI 0.3 to 0.87). Conclusion: Among children, COVID-19 pneumonia is frequent, and the risk was increased for those in the group of less than 3 years old and having increased body weight. Rhinorrhea was slightly associated with a lower risk. Physicians and care teams should consider these factors when treating this group of pediatric patients. Keywords: Pneumonia; COVID-19; Children; Pediatric