Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Exp Med. Mar 20, 2022; 12(2): 26-35
Published online Mar 20, 2022. 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
Adil Zhamankulov, Rafail Rozenson, Marina Morenko, Ulzhan Akhmetova, Alina Tyo, Dimitri Poddighe
Adil Zhamankulov, Rafail Rozenson, Marina Morenko, Ulzhan Akhmetova, Alina Tyo, Department of Children's diseases, Astana Medical University, First Children's Municipal Hospital, Nur-Sultan 010000, Kazakhstan
Dimitri Poddighe, Clinical Academic Department of Pediatrics, National Research Center for Maternal and Child Health, University Medical Center, Nur-Sultan 010000, Kazakhstan
Author contributions: Zhamankulov A and Rozenson R conceived the study; Zhamankulov A, Morenko M, Akhmetova U, Tyo A collected and provided the data; Zhamankulov A and Poddighe D organized and analyzed the data; Rozenson R, Morenko M, Poddighe D provided intellectual contribution; Zhamankulov A and Poddighe D wrote the manuscript; all authors have read and agreed to the published version of the manuscript.
Institutional review board statement: Institutional Review Board Statement: The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by local Ethics Committee [protocol No. 2020.3.7 approved by Local Bioethical Committee of NJSC (Astana Medical University)] in agreement with the ethical principles of the State Standard for Good Clinical Practice and Regulatory Law of the Republic of Kazakhstan "On Science", State Educational Standard of the Republic of Kazakhstan 5.01.024-2008 "Scientific Research").
Informed consent statement: Informed consent was obtained from guardians of all patients involved in the study.
Conflict-of-interest statement: The authors have no conflict of interest to declare.
Data sharing statement: Dataset can be available upon request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dimitri Poddighe, MD, MSc, PhD, Associate Professor, Director, Doctor, Pediatrics, National Research Center for Maternal and Child Health, No. 32 Turan Avenue, Nur-Sultan 010000, Kazakhstan. dimitri.poddighe@nu.edu.kz
Received: October 30, 2021
Peer-review started: October 30, 2021
First decision: December 27, 2021
Revised: December 29, 2021
Accepted: February 27, 2022
Article in press: February 27, 2022
Published online: March 20, 2022
Processing time: 137 Days and 1.6 Hours
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: Pediatric COVID-19; SARS-CoV-2; Pneumonia; C-reactive protein; Chest X-ray; Inflammatory parameters

Core Tip: This is a single-center pediatric case series of coronavirus 2019 disease (COVID-19) from Kazakhstan during the first wave of pandemic. We analyzed the main clinical aspects in those children diagnosed with pneumonia. In detail, we compared the clinical and laboratory characteristics of children affected with pneumonia in the presence (group 1) or absence (group 2) of severe acute respiratory syndrome coronavirus-2 infection. No significant differences were found between these study groups for any clinical and laboratory parameters, except for C-reactive protein (CRP). Of course, both pneumonia groups showed increased CRP values, overall; however, COVID-19 pneumonia group showed a significantly higher increase of CRP compared to pneumonia children without COVID-19.