Secondary Bacterial Pneumonia in Pediatrics with Influenza and COVID-19

Background: Differentiating between influenza, COVID-19, and secondary bacterial infections in hospitalized patients presents a significant challenge. Objectives: This study aimed to evaluate the occurrence of secondary bacterial pneumonia in pediatric patients with influenza and COVID-19 who were admitted to Mofid Hospital. Methods: This cross-sectional study involved pediatric patients admitted due to influenza and COVID-19 to Mofid Hospital from October to March 2023 (consensus sampling method), focusing on the occurrence of secondary bacterial pneumonia and its contributing factors. We examined the clinical, laboratory, and admission data of the patients. Nelson guidelines for the treatment of community-acquired pneumonia in children were used to assess the occurrence of outcomes. The data were analyzed through SPSS version 22 using chi-square or Fisher’s exact tests. A significance level of less than 0.05 was established. Results: A total of one hundred fifty-five pediatric patients were admitted to the hospital due to complications arising from COVID-19 and influenza. Among these, 32 patients, representing 20.64%, developed secondary bacterial pneumonia. Fever was the predominant clinical symptom, observed in all patients. Of the 32 patients with secondary pneumonia, 30 were treated with first-line antibiotics, while 2 required an additional regimen of colistin and linezolid. The severity of secondary bacterial pneumonia was significantly associated with the need for admission to the pediatric intensive care unit (PICU) and the development of complications (P < 0.05). Conclusions: The occurrence of secondary bacterial pneumonia in pediatric patients following COVID-19 and influenza was prevalent, and its severity can be affected by PICU admissions and the occurrence of pneumonia-related complications. Further studies with a larger sample size are required to generalize the findings.