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

Abstract

Background: The Severe Acute Respiratory Syndrome virus (SARS-CoV-2) had a great impact in the worldwide population. Because of personal protective equipment (PPE), children have not been exposed to the commonly circulating respiratory viruses, with an effect on pneumonia disease spreading. The aim of our study was to evaluate the different distribution of invasive procedures for complicated pneumonia in pre, intra and post pandemic period.

Methods: We conducted a retrospective analysis in children who underwent invasive procedures for complicated pneumonia, focusing on the winter season. Three periods were identified: pre-SARS-CoV-2 (14 months), pandemic (11 months) and post-SARS-CoV-2 (5 months). The invasive procedures considered were thoracentesis, chest tube placement, and video-assisted thoracoscopic surgery (VATS).

Results: A total of 67 children were admitted to our Institution for complicated pneumonia between November 2017 and March 2023 with a mean of 2.6, 1 and 4.4 per months respectively, in pre-pandemic and post-SARS-CoV-2. A chest tube was placed in 24% of pre-pandemic patients, 9% of pandemic and 50% of post-pandemic (P=0.002). Fifty percent of post-pandemic patients required VATS (P=0.014). Chest CT scans demonstrated necrotizing pneumonia with higher frequency in post-SARS-CoV-2 period (P=0.031).

Conclusions: PPE preserved from SARS-CoV-2 but influenced the spread of other pathogens. We reported an increasing number of complicated pneumonias requiring surgery and of necrotizing pneumonia in the post-pandemic period.