Department of Pediatrics, Faculty of Medicine, Khon Kaen University, 123 Mittraphap Road, Muang, Khon Kaen 40002, Thailand.
Viruses. 2024 Jun 12;16(6):946. doi: 10.3390/v16060946.
The COVID-19 pandemic, caused by SARS-CoV-2, has posed significant health challenges worldwide. While children generally experience less severe illness compared to adults, pneumonia remains a substantial risk, particularly for those under five years old. This study examines the clinical characteristics and treatment outcomes of pediatric COVID-19 pneumonia patients treated with favipiravir in Thailand, aiming to identify associated factors for pneumonia. A retrospective review was performed on pediatric patients aged 1 month to 18 years hospitalized with COVID-19 at Srinagarind Hospital, Khon Kaen University, from 13 January 2020 to 15 November 2021. Data on demographics, clinical symptoms, treatment, and outcomes were collected, and logistic regression analysis was used to identify factors associated with pneumonia. Among 349 hospitalized children, the median age was 8 years, with 51.9% being male. Symptoms included a fever (100%), a cough (74.2%), and a rash (24.9%). COVID-19 pneumonia was diagnosed in 54.7% of the children. Favipiravir was administered as the standard treatment, showing mild adverse effects, including a rash (4.3%) and nausea (2.8%). Monocytosis was significantly associated with COVID-19 pneumonia (aOR 30.85, 95% CI: 9.03-105.41, < 0.001), with an ROC curve area of 0.77 (95% CI: 0.71-0.83). Pediatric COVID-19 patients typically exhibit mild-to-moderate symptoms, with pneumonia being common in the early pandemic phase. Monocytosis is a significant factor associated with COVID-19 pneumonia. Favipiravir demonstrated mild adverse effects. Further studies are needed to validate these findings across different settings and phases of the pandemic.
新型冠状病毒(SARS-CoV-2)引发的 COVID-19 大流行给全球带来了巨大的健康挑战。尽管儿童感染新冠病毒的症状通常比成年人轻,但肺炎仍然是一个重大风险,尤其是五岁以下儿童。本研究旨在分析泰国儿童 COVID-19 肺炎患者使用法匹拉韦治疗的临床特征和治疗结果,以确定肺炎的相关因素。回顾性分析 2020 年 1 月 13 日至 2021 年 11 月 15 日在孔敬大学诗琳通医院住院的年龄在 1 个月至 18 岁的 COVID-19 患儿的临床资料。收集人口统计学、临床症状、治疗和结局数据,并进行逻辑回归分析,以确定与肺炎相关的因素。349 名住院患儿的中位年龄为 8 岁,男性占 51.9%。症状包括发热(100%)、咳嗽(74.2%)和皮疹(24.9%)。54.7%的患儿诊断为 COVID-19 肺炎。标准治疗方案使用法匹拉韦,副作用较轻,包括皮疹(4.3%)和恶心(2.8%)。单核细胞增多症与 COVID-19 肺炎显著相关(aOR 30.85,95%CI:9.03-105.41,<0.001),ROC 曲线下面积为 0.77(95%CI:0.71-0.83)。儿科 COVID-19 患者通常表现为轻至中度症状,肺炎在大流行早期阶段较为常见。单核细胞增多症是 COVID-19 肺炎的一个重要相关因素。法匹拉韦的副作用较轻。需要进一步研究来验证这些发现是否在不同的环境和大流行阶段成立。