The host response of COVID-19 and identification from other aetiologies
of community-acquired pneumonia in children
Abstract
Objectives: Community-acquired pneumonia (CAP) was a common
respiratory tract infection in children, which can be caused by various
pathogens, including bacteria, mycoplasma (MP), respiratory syncytial
virus (RSV), and recently SARS-CoV-2 are the most widespread. We attempt
to distinguish common and pathogen-specific host response
characteristics by comparing the CAP of different pathogens.
Methods: We included 200 CAP hospitalized cohort caused by
SARS-CoV-2 (COVID-19, n=50), mycoplasma (CAP-MP, n=50), RSV (CAP-RSV,
n=50) and other bacteria (CAP-Bacteria, n=50), of whom were balanced the
potentially confounding factors (such as age and gender) based on
Propensity Score Matching algorithm(PSM). We compared hematologic and
biochemical indicators for different CAPs, samples were taken within 48
hours of admission. Results: Main clinical features of COVID-19
were fever, faster heart rate and lower antibiotic use. Notably, markers
of immuno-inflammatory, including white blood cell, lymphocyte and
procalcitonin (PCT) were not different among the CAP groups. Biomarkers
reflecting nutrient metabolism showed total protein (TP) and albumin
(ALB) levels in the COVID-19 group were lower than those in the CAP-MP
group, the creatinine and urea levels of the COVID-19 patients were
higher than that of CAP-MP group. The serum sodium and calcium levels in
the COVID-19 group were the lowest and significantly lower than that in
the CAP-MP group, while serum phosphorus levels were opposite. Moreover,
we observed that the creatine kinase (CK) and creatine kinase-MB (CK-MB)
levels in the COVID-19 were higher than those in the CAP-MP groups.
Conclusions: Our study revealed common and unique
pathophysiological features of different pathogensāassociated CAP, which
may facilitate the pathogen-specific precision diagnosis and treatment.