Pediatric Health, Medicine and Therapeutics (Mar 2024)
Analysis of Childhood Pneumonia: A Comparison Between the Pre- and During the COVID-19 Pandemic in a Reference Hospital in Brazil
Abstract
Eduardo Jorge Fonseca Lima,1,2 Luiza Campos Corrêa de Araújo,1 Karine Ferreira Agra,2 Ana Julia Xavier Mendoza,1 Julia Pierre de Brito Siebra,1 Carmina Silva dos Santos2,3 1Department of Medicine, Faculdade Pernambucana de Saúde, Recife, Pernambuco, Brazil; 2Lato Sensu Postgraduate Department, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Pernambuco, Brazil; 3Nursing Department, Faculdade Pernambucana de Saúde, Recife, Pernambuco, BrazilCorrespondence: Eduardo Jorge Fonseca Lima, Instituto de Medicina Integral Professor Fernando Figueira, Rua dos Coelhos, N° 300, Boa Vista, Recife, Pernambuco, Brazil, Tel +5581 21224166, Email [email protected]: Community-acquired pneumonia (CAP) is one of the most common causes of childhood morbidity and mortality, causing about two million deaths per year worldwide. The complicated CAP (CCAP) results from the worsening of CAP. Their incidence has reduced in the last 30 years due to vaccination. However, the coronavirus disease (COVID-19) pandemic reduced vaccination coverage, resulting in increased incidence of CCAP in 2021 and 2022.Objective: To analyze the clinical and epidemiological profile of CAP in children under five years of age in two periods: pre- (2018 to 2019) and during the COVID-19 pandemic (2020 to 2022).Methods: This cross-sectional retrospective study was conducted at the Professor Fernando Figueira Institute of Integral Medicine (IMIP). We analyzed the sociodemographic and clinical variables of children with CAP aged below five years who were admitted to IMIP from 2018 to 2022. Analysis encompassed the Pearson’s Chi-square test, Fischer’s exact test, and Student’s T tests.Results: A total of 468 children were analyzed: 382 in the pre-pandemic period and 86 during the COVID-19 pandemic. Concerning the antibiotic therapy, the most prescribed was Ampicillin (45.00%) in both periods. The combination of Oxacillin and Ceftriaxone was prescribed in 6.86% of cases in the pre-pandemic period; this value increased to 20.90% during the COVID-19 pandemic. Pleural effusion represented 12.10% of cases in the pre-pandemic period and 24.40% during the COVID-19 pandemic. The presence of pleural empyema went from 1.60% to 8.20%, and necrotizing pneumonia from 1.30% to 5.90% in the respective periods. Regarding ICU admission, 5.30% were admitted during the pre-pandemic period and 34.10% during the COVID-19 pandemic. Clinical suspicion of influenza presented a positivity rate of 17.60%.Conclusion: Children with CAP presented a higher frequency of complications during the COVID-19 pandemic. Further research is needed to find the cause of increased CAP complications in this period.Keywords: pneumonia, bacterial, children, COVID-19, pleural effusion
