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Complicated pneumonia requiring invasive procedures in children in the post-COVID period: monocentric experience

Chiara Costantini1, Riccardo Guanà2, Elisa Zambaiti3

  • 1Pediatric Surgery Unit, Santobono Children's Hospital, Naples, Italy.

Minerva Pediatrics
|March 25, 2025
PubMed

Insights

The COVID-19 pandemic saw fewer common respiratory viruses, leading to more complicated childhood pneumonia. Post-pandemic, there was a significant rise in surgeries and necrotizing pneumonia cases in children.

Area of Science:

  • Pediatric Pulmonology
  • Infectious Diseases
  • Epidemiology

Background:

  • The COVID-19 pandemic and associated personal protective equipment (PPE) use altered children's exposure to common respiratory viruses.
  • This altered exposure pattern potentially impacted the incidence and severity of childhood pneumonia.

Purpose of the Study:

  • To evaluate the distribution of invasive procedures for complicated pediatric pneumonia across pre-pandemic, pandemic, and post-pandemic periods.
  • To analyze trends in surgical interventions and necrotizing pneumonia following the SARS-CoV-2 pandemic.

Main Methods:

  • Retrospective analysis of 67 children with complicated pneumonia requiring invasive procedures.
  • Data collected across three periods: pre-pandemic (14 months), pandemic (11 months), and post-pandemic (5 months).
  • Invasive procedures included thoracentesis, chest tube placement, and video-assisted thoracoscopic surgery (VATS).

Main Results:

  • Chest tube placement increased significantly in the post-pandemic period (50%) compared to pre-pandemic (24%) and pandemic (9%) phases (P=0.002).
  • Video-assisted thoracoscopic surgery (VATS) was required in 50% of post-pandemic patients (P=0.014).
  • Necrotizing pneumonia was diagnosed more frequently in the post-pandemic period (P=0.031).

Conclusions:

  • Personal protective equipment (PPE) use during the pandemic, while limiting SARS-CoV-2 spread, influenced the epidemiology of other respiratory pathogens.
  • A notable increase in complicated pneumonias requiring surgical intervention and a rise in necrotizing pneumonia were observed in the post-pandemic era.
Abstract

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