Patterns of the community-acquired pneumonia course associated with SARS-CoV-2 in children

N.A. Belykh¹, N.A. Anikeeva¹, A.Yu. Panferukhina¹, N.N. Fokicheva², S.A. Shilina², 

M.V. Faletrov², N.Yu. Fedoseeva², V.V. Mayboroda¹, V.V. Goryachev², O.A. Solovyova¹

¹Ryazan State Medical University, Ryazan

²City Clinical Hospital No. 11, Ryazan

Aim: to study the clinical and laboratory patterns of community-acquired pneumonia course associated with SARS-CoV-2 in children.

Patients and Methods: a study included 55 children (30 boys, 25 girls) hospitalized in City Clinical Hospital No. 11 (Ryazan) from April 2020 to March 2021 with an established diagnosis: COVID-19, community-acquired pneumonia.

Results: among the examined patients, there was a predominance of children over 12 years (61.8%). 32 (58.2%) patients had an intrafamilial transmission with laboratory-confirmed cases of COVID-19 in relatives. 17 (30.9%) patients had various comorbidities, mainly obesity, diseases of the cardiovascular and central nervous system. The main clinical manifestations in patients who underwent the follow-up were intoxication, respiratory tract lesions and gastrointestinal symptoms. In 63.6% of cases, lung damage corresponded to mild severity (CT-1). IgM antibodies to Mycoplasma pneumoniae were detected in 15 (27.3%) patients, and pathogens of different species (among which pneumococci were the dominant pathogens) were sown by bacteriologic culture technique when analyzing a throat swab in 29 (52.7%) children. At the same time, mixed mycoplasma pneumonia infection was registered in 6 (10.9%) cases. A direct correlation was revealed between the stage of lung dama ge and C-reactive protein level (r=0.31, p=0.019), ALT (r=0.30, p=0.05) and lactate dehydrogenase (r=0.27, p=0.05), as well as the presence of concomitant diseases (r=0.41, p=0.002). There was a positive trend in the condition of all patients during the ongoing therapy.

Conclusion: in SARS-CoV-2-associated pneumonia, concomitant respiratory infection of mycoplasma, pneumococcal and mixed (Mycoplasma pneumoniae) etiology was most commonly detected (16.4, 12.7 and 10.9%, respectively). A statistically significant positive correlation was found between the stage of lung damage and the presence of concomitant diseases, as well as a deviation from the norm of several laboratory parameters. In timely treatment, most patients had a favorable disease outcome.

Keywords: children, community-acquired pneumonia, new coronavirus infection, comorbid pathology, viral pneumonia, Mycoplasma pneumoniae, pneumococcal pneumonia.