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Predictors of pulmonary involvement in children with COVID-19: How strongly associated is viral load?
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  • Nurhayat Yakut,
  • Kahraman Yakut,
  • Zeynep Sarihan,
  • Irem Kabasakal,
  • Murat Aydin,
  • Nuran Karabulut
Nurhayat Yakut
Sakura Sogo Byoin

Corresponding Author:[email protected]

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Kahraman Yakut
Sakura Sogo Byoin
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Zeynep Sarihan
Sakura Sogo Byoin
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Irem Kabasakal
Sakura Sogo Byoin
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Murat Aydin
Sakura Sogo Byoin
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Nuran Karabulut
Sakura Sogo Byoin
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Abstract

This study aimed to investigate epidemiological, clinical, and laboratory features of children with COVID-19 to identify predictors for pulmonary involvement. We conducted a retrospective, single-center study of pediatric COVID-19 at a tertiary care hospital in Turkey between December 2020 and June 2021. A total of 126 children (70 males, 55.6%) were examined during the study period. Their mean age was 74.73 ± 81.11 months (range, 1–216 months). The most frequent COVID-19 symptoms were fever (65.9%), cough (52.4%), and shortness of breath (18.3%). Ten patients required noninvasive mechanical ventilation. Sixty-nine patients (54.8%) had pneumonia. Longer duration of fever and the presence of cough were significantly associated with pulmonary involvement. In children with pneumonia, the C-reactive protein (CRP), procalcitonin levels, erythrocyte sedimentation rate (ESR), and viral load were significantly higher and lymphocyte and thrombocyte counts were significantly lower than in children without pneumonia. The cutoff viral load, CRP, and procalcitonin values for predicting pulmonary involvement were 26.5 cycle threshold (Ct; 95% confidence interval [CI], 0.54–0.74; sensitivity, 0.65; specificity, 0.56; area under curve [AUC]: 0.647, p = 0.005), 7.85 mg/L (95% CI, 0.56–0.75; sensitivity, 0.66; specificity, 0.64; AUC = 0.656; p = 0.003) and 0.105 ng/mL (95% CI, 0.52–0.72; sensitivity, 0.55; specificity, 0.58; AUC = 0.626; p = 0.02), respectively. High CRP, procalcitonin levels, ESR, and viral load and low lymphocyte and thrombocyte counts can predict pulmonary involvement in children with COVID-19, so better management may be provided for good prognosis.
01 Jun 2022Submitted to Pediatric Pulmonology
01 Jun 2022Submission Checks Completed
01 Jun 2022Assigned to Editor
03 Jun 2022Reviewer(s) Assigned
20 Jul 2022Review(s) Completed, Editorial Evaluation Pending
30 Jul 2022Editorial Decision: Revise Minor
17 Aug 20221st Revision Received
17 Aug 2022Submission Checks Completed
17 Aug 2022Assigned to Editor
17 Aug 2022Reviewer(s) Assigned
20 Aug 2022Review(s) Completed, Editorial Evaluation Pending
24 Aug 2022Editorial Decision: Revise Minor
01 Sep 20222nd Revision Received
01 Sep 2022Submission Checks Completed
01 Sep 2022Assigned to Editor
01 Sep 2022Reviewer(s) Assigned
18 Sep 2022Review(s) Completed, Editorial Evaluation Pending
20 Sep 2022Editorial Decision: Accept
30 Sep 2022Published in Pediatric Pulmonology. 10.1002/ppul.26165