ABSTRACT
Coronavirus disease 2019 (COVID-19) is usually less severe in children and adolescents than in adults. However, it can cause severe respiratory illness in a small proportion of children with risk factors. Here, we report a rare case of a 10-year-old boy with postinfectious bronchiolitis obliterans that developed after pneumonia caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). This patient was previously healthy apart from a high body mass index (BMI, 30.13; 99.6th percentile for the age bracket), history of preterm birth (35 weeks), and low birth weight (1,850 g). He had persistent exertional dyspnea after recovering from SARS-CoV-2-related pneumonia. Spirometry revealed obstructive lung disease with the following results: predicted forced vital capacity (FVC% pred ), 71%; forced expiratory volume in 1 second (FEV 1 % pred ), 63%; FEV 1 /FVC, 0.81; and forced expiratory flow 25-75 % pred , 55%. Chest computed tomography showed multifocal areas of parenchymal hyperlucency and mosaic attenuation in both lungs. This case suggests that careful observation of children with obesity and low birth weight is necessary after recovery from SARS-CoV-2-related pneumonia.
ABSTRACT
Purpose@#Patients with Mycoplasma pneumoniae pneumonia (MPP) can develop atelectasis, and some cases of atelectasis may persist for over 4 weeks. However, the risk factors for the development and persistence of atelectasis ( > 4 weeks) in children with MPP and their clinical characteristics remain understudied. We aimed to investigate the clinical characteristics and associated factors of MPP with atelectasis in children. @*Methods@#We retrospectively analyzed the medical records of 477 children with MPP treated at Pusan National University Yangsan Hospital from November 2014 to March 2020. Demographics, clinical information, laboratory data, and radiological findings were collected from all patients. The patients were divided into 2 groups according to the presence of atelectasis with MPP. The group with atelectasis was further divided into 2 groups according to whether atelectasis was improved. @*Results@#Among 477 children with MPP, 105 developed atelectasis, and 34 showed persistent atelectasis. Children with atelectasis had longer lengths of hospitalization than children without atelectasis. High lactate dehydrogenase (LDH) levels and whole lobar consolidation were independently associated factors for presenting with atelectasis, and long macrolide therapy duration before admission ( > 3 days) was related to persistent atelectasis ( > 4 weeks). @*Conclusion@#High LDH levels and whole lobar consolidation were independent associated factors for presenting with atelectasis, and a long macrolide therapy duration before admission was associated with persistent atelectasis. Careful observation and management of children with these associated factors for atelectasis will improve the prognosis of children with MPP.