Factors Associated with Severe Community-Acquired Pneumonia Among Children Under Five in the Post-COVID-19 Era
Keywords:
community-acquired pneumonia, pediatrics, post-COVID-19 eraAbstract
Objectives : This study aims to identify factors associated with severe community-acquired pneumonia among children under five years of age in the post-COVID-19 era.
Methods : This was a retrospective cohort study conducted between January 2022 and June 2023 in children aged 1 month to 5 years diagnosed with community-acquired pneumonia at Mahasarakham Hospital. Pneumonia severity was classified according to the Pediatric Respiratory Severity Score (PRESS) into mild and severe groups. Data collection was performed using patient medical records, and statistical analysis included descriptive and inferential methods to calculate adjusted odds ratios (ORadj) and p-values.
Results : Among 334 children under five diagnosed with pneumonia, 147 (44.01%) had severe pneumonia. Multivariate analysis revealed statistically significant risk factors, including preterm birth (ORadj=3.1, 95% CI: 1.4-6.7), the presence of at least two respiratory symptoms (tachypnea, desaturation, and retraction; ORadj=5.5, 95% CI: 3.9-7.9), laboratory findings of leukocytosis with neutrophil predominance (ORadj=4.2, 95% CI: 1.6-10.7), and abnormal chest X-rays showing patchy infiltration (ORadj=10.9, 95% CI: 1.1-113.3).
Conclusion : Factors associated with severe pneumonia included preterm birth, the presence of at least two respiratory symptoms (tachypnea, desaturation, and retraction), leukocytosis with neutrophil predominance, and chest X-ray abnormalities such as patchy infiltration. Previous COVID-19 infection was not associated with severe pneumonia.
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