Lung damage caused by COVID-19 and community-acquired pneumonia in children: Сomparative clinical and laboratory analysis

Abstract

The study is devoted to the challenge of interpreting the lung damage associated with COVID-19 in children and the necessity for antimicrobial therapy in this disease. The aim of the research was a comparative analysis of clinical, radiological and laboratory signs in children with COVID-19 and community-acquired pneumonia (CAP). Methods. The observational comparative study included medical records of 53 children with the lung damage at the age of 1 year 4 months up to 17 years old, hospitalized for the period from June to August 2020. All children were tested for Severe acute respiratory syndrome-related coronavirus-2 (SARS-CoV-2) by polymerase chain reaction (PCR). 34 patients with SARS-CoV-2⁺ were diagnosed with COVID-19 and 19 children with SARS-CoV-2^– were diagnosed with CAP. The assessment included medical history, clinical, laboratory and radiological changes. Results. Distinctive reliable clinical, laboratory, and X-ray signs of lung damage in COVID-19 compared to CAP were olfactory impairment (26%), bilateral lung damage (23%), erythrocytosis, leukopenia (20.6%), granulocyto- and monocytopenia, lower levels of reactive protein (CRP). Irrational prescribing of antibiotics (94%) was detected in the group of patients with COVID-19. Conclusion. We established the reliable clinical, laboratory and radiological features of COVID-19 in children, which indicate the viral nature of lung damage.