Abstract:

Objective To investigate the clinical characteristics and etiological analysis of severe pneumonia complicated with acute respiratory failure (SP-ARF) in children before and after the coronavirus disease 2019 (COVID-19) outbreak in Suzhou. Methods This study retrospectively analyzed the medical records of all SP-ARF children admitted to the Children’s Hospital of Soochow University from January 2018 to December 2021, and they were divided into pre-epidemic group (January 2018 to December 2019) and post-epidemic group (January 2020 to December 2021) according to the outbreak time. The clinical data and etiological results of the two groups were analyzed. Results There were 141 cases in the pre-epidemic group and 127 cases in the post-epidemic group. The month-age of children with SP-ARF in the post-epidemic group were older than those of pre-epidemic group (P<0.05), and with a higher proportion of combined underlying diseases (P<0.05). The peak period of SP-ARF was from October to December every year regardless of before or after the epidemic. The positive rate of etiological examination in pre-epidemic group was 82.27%(116/141). The top 4 bacteria were in order of Gram-negative bacteria (36.88%), Gram-positive bacteria (26.95%), viruses (26.95%), and mycoplasma pneumoniae (9.22%). The positive rate of etiological examination in posr-epidemic group was 85.83% (109/127), and the top 4 bacteria were in order of Gram-negative bacteria (37.80%), virus (28.35%), Gram-positive bacteria (22.83%), and Mycoplasma pneumoniae (9.45%). Conclusion After the epidemic, the proportion of children without underlying diseases developing SP-ARF decreased, SP-ARF occurred frequently from October to December every year regardless of before or after the epidemic. The pathogens of the two groups were mainly bacteria, with highest proportion of Gram-negative bacteria.

Key words: pneumonia, respiratory insufficiency, COVID-19