Zhongwei Jia1,2,3, Xiangyu Yan1,2,3, Liwei Gao4,5, Shenggang Ding6, Yan Bai7, Yuejie Zheng8, Yuxia Cui9, Xianfeng Wang10, Jingfeng Li11, Gen Lu12, Yi Xu12, Xiangyu Zhang1,2,3, Junhua Li13, Ning Chen14, Yunxiao Shang14, Mingfeng Han15, Jun Liu4,5, Hourong Zhou17,18, Cen Li9, Wanqiu Lu19, Jun Liu4,5, Lina Wang4,5, Qihong Fan20, Jiang Wu21, Hanling Shen22, Rong Jiao23, Chunxi Chen24, Xiaoling Gao25, Maoqiang Tian26, Wei Lu27, Yonghong Yang28,29, Gary Wing-Kin Wong30, Tianyou Wang31, Runming Jin7, Adong Shen32, Baoping Xu4,5, Kunling Shen4. 1. School of Public Health, Peking University, Beijing, China. 2. Center for Intelligent Public Health, Institute for Artificial Intelligence, Peking University, Beijing, China. 3. Center for Drug Abuse Control and Prevention, National Institute of Health Data Science, Peking University, Beijing, China. 4. China National Clinical Research Center for Respiratory Diseases, Department of Respiratory Medicine, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China. 5. Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences, Beijing, China. 6. Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei, China. 7. Pediatric Department, Union Hospital, Tongji Medical College, Huazhong University of Science And Technology, Hubei, China. 8. Department of Respiratory Medicine, Shenzhen Children's Hospital, Shenzhen, China. 9. Department of Pediatrics, Guizhou Provincial People's Hospital, Guizhou, China. 10. Department of Pediatrics, Shenzhen Third People's Hospital, Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China. 11. Department of Pediatrics, Taihe Hospital, Shiyan, China. 12. Department of Pediatric, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China. 13. Department of Pediatrics, Xiangyang Central Hospital, Xiangyang, China. 14. Department of Pediatric, Shengjing Hospital of China Medical University, Liaoning, China. 15. Department of Respiratory Medicine, The Second People's Hospital of Fuyang, Anhui, China. 16. Department of Pediatrics, The People Hospital of Bozhou, Anhui, China. 17. Department of General Practice, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China. 18. Office of Academic Research, Jiangjunshan Hospital, Guizhou, China. 19. Department of Pediatrics, The Affiliated Hospital of Guizhou University, Guizhou, China. 20. Department of Pediatrics, Jingzhou First People's Hospital, Jingzhou, China. 21. Department of Pediatrics, Huangshi Maternity and Child Health Care Hospital, Huangshi, China. 22. Department of Pediatrics, Suizhou Maternity and Child Health Care Hospital, Suizhou, China. 23. Department of Pediatrics, Xiangyang First People's Hospital, Xiangyang, China. 24. Department of Pediatrics, Xishui People's Hospital, Huanggang, China. 25. Department of Pediatrics, People's Hospital of Tuanfeng County, Huanggang, China. 26. Department of Pediatrics, Tongren People's Hospital of Guizhou Province, Guizhou, China. 27. Department of Pediatrics, Yichang Central People's Hospital, Yichang, China. 28. Beijing Pediatric Research Institute, Beijing, China. 29. Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China. 30. Department of Pediatrics, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China. 31. Center of Hematologic Oncology, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China. 32. Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China.
Abstract
Background: The pandemic of Coronavirus Disease 2019 (COVID-19) brings new challenges for pediatricians, especially in the differentiation with non-COVID-19 pneumonia in the peak season of pneumonia. We aimed to compare the clinical characteristics of pediatric patients with COVID-19 and other respiratory pathogens infected pneumonias. Methods: We conducted a multi-center, cross-sectional study of pediatric inpatients in China. Based on pathogenic test results, pediatric patients were divided into three groups, including COVID-19 pneumonia group, Non-COVID-19 viral (NCV) pneumonia group and Non-viral (NV) pneumonia group. Their clinical characteristics were compared by Kruskal-Wallis H test or chi-square test. Results: A total of 636 pediatric pneumonia inpatients, among which 87 in COVID-19 group, 194 in NCV group, and 355 in NV group, were included in analysis. Compared with NCV and NV patients, COVID-19 patients were older (median age 6.33, IQR 2.00-12.00 years), and relatively fewer COVID-19 patients presented fever (63.2%), cough (60.9%), shortness of breath (1.1%), and abnormal pulmonary auscultation (18.4%). The results were verified by the comparison of COVID-19, respiratory syncytial virus (RSV) and influenza A (IFA) pneumonia patients. Approximately 42.5%, 44.8%, and 12.6% of the COVID-19 patients presented simply ground-glass opacity (GGO), simply consolidation, and the both changes on computed tomography (CT) scans, respectively; the proportions were similar as those in NCV and NV group (p>0.05). Only 47.1% of COVID-19 patients had both lungs pneumonia, which was significantly lower than that proportion of nearly 80% in the other two groups. COVID-19 patients presented lower proportions of increased white blood cell count (16.5%) and abnormal procalcitonin (PCT) (10.7%), and a higher proportion of decreased lymphocyte count (44.0%) compared with the other two groups. Conclusion: Majority clinical characteristics of pediatric COVID-19 pneumonia patients were milder than non-COVID-19 patients. However, lymphocytopenia remained a prominent feature of COVID-19 pediatric pneumonia.
Background: The pandemic of Coronavirus Disease 2019 (COVID-19) brings new challenges for pediatricians, especially in the differentiation with non-COVID-19 pneumonia in the peak season of pneumonia. We aimed to compare the clinical characteristics of pediatric patients with COVID-19 and other respiratory pathogens infected pneumonias. Methods: We conducted a multi-center, cross-sectional study of pediatric inpatients in China. Based on pathogenic test results, pediatric patients were divided into three groups, including COVID-19 pneumonia group, Non-COVID-19 viral (NCV) pneumonia group and Non-viral (NV) pneumonia group. Their clinical characteristics were compared by Kruskal-Wallis H test or chi-square test. Results: A total of 636 pediatric pneumonia inpatients, among which 87 in COVID-19 group, 194 in NCV group, and 355 in NV group, were included in analysis. Compared with NCV and NV patients, COVID-19patients were older (median age 6.33, IQR 2.00-12.00 years), and relatively fewer COVID-19patients presented fever (63.2%), cough (60.9%), shortness of breath (1.1%), and abnormal pulmonary auscultation (18.4%). The results were verified by the comparison of COVID-19, respiratory syncytial virus (RSV) and influenza A (IFA) pneumoniapatients. Approximately 42.5%, 44.8%, and 12.6% of the COVID-19patients presented simply ground-glass opacity (GGO), simply consolidation, and the both changes on computed tomography (CT) scans, respectively; the proportions were similar as those in NCV and NV group (p>0.05). Only 47.1% of COVID-19patients had both lungs pneumonia, which was significantly lower than that proportion of nearly 80% in the other two groups. COVID-19patients presented lower proportions of increased white blood cell count (16.5%) and abnormal procalcitonin (PCT) (10.7%), and a higher proportion of decreased lymphocyte count (44.0%) compared with the other two groups. Conclusion: Majority clinical characteristics of pediatric COVID-19 pneumoniapatients were milder than non-COVID-19patients. However, lymphocytopenia remained a prominent feature of COVID-19 pediatric pneumonia.
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