Comparison of pneumonia features in children caused by SARS-CoV-2 and other viral respiratory pathogens.

BACKGROUND: Pneumonia is a frequent manifestation of coronavirus disease 2019 (COVID-19) in hospitalized children. METHODS: The study involved 80 hospitals in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Spanish Pediatric National Cohort. Participants were children <18 years, hospitalized with SARS-CoV-2 community-acquired pneumonia (CAP). We compared the clinical and radiological characteristics of SARS-CoV-2-associated CAP with CAP due to other viral etiologies from ValsDance (retrospective) cohort. RESULTS: In total, 151 children with SARS-CoV-2-associated CAP and 138 with other viral CAP were included. Main clinical features of SARS-CoV-2-associated CAP were cough, fever, or dyspnea. Lymphopenia was found in 43% patients and 15% required admission to the pediatric intensive care unit (PICU). Chest X-ray revealed condensation (42%) and other infiltrates (58%). Compared with CAP from other viral pathogens, COVID-19 patients were older, with lower C-reactive protein (CRP) levels, less wheezing, and greater need of mechanical ventilation (MV). There were no differences in the use of continuous positive airway pressure (CPAP) or HVF, or PICU admission between groups. CONCLUSION: SARS-CoV-2-associated CAP in children presents differently to other virus-associated CAP: children are older and rarely have wheezing or high CRP levels; they need less oxygen but more CPAP or MV. However, several features overlap and differentiating the etiology may be difficult. The overall prognosis is good.

Tumor miofibroblástico en la edad pediátrica. A propósito de 3 casos / Paediatric myofibroblastic tumours. A presentation of three cases

El tumor miofibroblástico inflamatorio es una enfermedad poco frecuente en la edad pediátrica, en general benigna, aunque con posible evolución a malignidad. Se presentan 3 pacientes con tumor miofibroblástico en edad pediátrica, en diferentes localizaciones: pulmonar, gástrica e intestinal. Las características clínicas dependen del lugar en el que esté ubicado el tumor. Generalmente, hay fiebre prolongada en todos, sin gran afectación del estado general. En el primer caso, la hematemesis era su primer síntoma, mientras que en el segundo la anemia y la fiebre obligaron a la realización de una imagen abdominal. En el tercer caso fueron la fiebre, la tos y los síntomas respiratorios los que alertaban acerca de una posible tumoración pulmonar. En este caso se obtuvo un cultivo positivo para una micobacteria atípica: Mycobacterium avium. Todos los casos cursan con aumento de proteína C reactiva, velocidad de sedimentación globular, anemia, trombocitosis y aumento de gammaglobulinas. La evolución es favorable; la cirugía es curativa siempre y cuando la resección sea total; el diagnóstico es anatomopatológico. Los autores quieren destacar la precocidad en el diagnóstico de uno de los pacientes (3 meses), dato no hallado en la literatura médica (AU)

There cases of paediatric inflammatory myofibroblastic tumours in different locations are presented. This a rare benign disease, that can develop into malignant forms. Clinical features are associated with the location. Fever was the main symptom in all our cases. The symptoms that indicated the location of the tumour were, haematemesis in the first case, and respiratory disease in the third. ,In the third case our patient was diagnosed with tuberculosis due to mycobacterium avium. All cases had increased CRP, ESR, thrombocytosis and high levels of gamma globulins. Surgery is curative if total resection is possible, and the diagnosis is made by histopathology. We would like to emphasise the early development in the second case as this was a 3 months-old infant (AU)

Síndrome PFAPA, un reto para el pediatra / PFAPA syndrome: a challenge in pediatrics

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