Features of the course of pneumonia in children with coronavirus infection

BACKGROUND: The most frequent complication of coronavirus infection (COVID-19) in young children is severe viral pneumonia.

AIM: To reveal the features of the course of coronavirus pneumonia in children.

MATERIALS AND METHODS: A retrospective analysis of 54 case histories of children with coronavirus pneumonia, aged 1 month to 15 years, who received inpatient treatment in the Department of Pulmonology was performed.

RESULTS: The disease was most often registered in children of the first three years of life (66,7%). 49 (90,7%) children turned out to be from family foci of coronavirus infection. The majority of children (44–81.5%) had signs of respiratory failure of I-II degree. Polymerase chain reaction (PCR) for the presence of coronavirus was positive in 37 (68.5%) children. Radiologically, bilateral infiltrates were detected predominantly in the middle and lower parts of the lungs. The multisystem inflammatory syndrome associated with SARS-CoV-2 was characterized by persistent fever, multiple organ damage and clinical and laboratory shifts.

The vast majority of cases involved transmission from adult patients. The disease most often developed in children under 3 years of age. The course of the disease is accompanied by the development of grade I–II respiratory failure and intoxication. PCR for the presence of coronavirus may be negative due to late admission of patients to the hospital. Radiological changes were characterized by extensive bilateral lesions mainly in the lower and middle lobes of the lungs. Persistent fever, multiorgan lesions, clinical and laboratory shifts in coronavirus pneumonia in children indicate the development of multisystem inflammatory syndrome associated with SARS-CoV-2.

CONCLUSIONS: Pneumonia in most cases proceeded with the development of respiratory failure, symptoms of gastrointestinal tract damage, a pronounced intoxication syndrome. At the same time, there was revealed inconsistency of radiologically extensive lung lesions with more scanty auscultatory data.