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Satdhabudha A, Chaiyakulsil C, Uppala R, Niyomkarn W, Tovichien P, Norasettekul V, Ruangnapa K, Smathakanee C, Choursamran B, Kulbun A, Jaroenying R, Kamalaporn H, Sriboonyong T, Roekworachai K, Sunkonkit K, Tangsathapornpong A, Bunjoungmanee P, Pao-in W, Thaweekul P, Tantiyavarong P, Ratanavongkosol T, Thongnual C, Sritipsukho P, Deerojanawong J. Development and validation of the predictive score for pediatric COVID-19 pneumonia: A nationwide, multicenter study. PLoS One 2022; 17:e0273842. [PMID: 36037228 PMCID: PMC9423652 DOI: 10.1371/journal.pone.0273842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 08/16/2022] [Indexed: 12/03/2022] Open
Abstract
Background Due to the possibility of asymptomatic pneumonia in children with COVID-19 leading to overexposure to radiation and problems in limited-resource settings, we conducted a nationwide, multi-center study to determine the risk factors of pneumonia in children with COVID-19 in order to create a pediatric pneumonia predictive score, with score validation. Methods This was a retrospective cohort study done by chart review of all children aged 0–15 years admitted to 13 medical centers across Thailand during the study period. Univariate and multivariate analyses as well as backward and forward stepwise logistic regression were used to generate a final prediction model of the pneumonia score. Data during the pre-Delta era was used to create a prediction model whilst data from the Delta one was used as a validation cohort. Results The score development cohort consisted of 1,076 patients in the pre-Delta era, and the validation cohort included 2,856 patients in the Delta one. Four predictors remained after backward and forward stepwise logistic regression: age < 5 years, number of comorbidities, fever, and dyspnea symptoms. The predictive ability of the novel pneumonia score was acceptable with the area under the receiver operating characteristics curve of 0.677 and a well-calibrated goodness-of-fit test (p = 0.098). The positive likelihood ratio for pneumonia was 0.544 (95% confidence interval (CI): 0.491–0.602) in the low-risk category, 1.563 (95% CI: 1.454–1.679) in the moderate, and 4.339 (95% CI: 2.527–7.449) in the high-risk. Conclusion This study created an acceptable clinical prediction model which can aid clinicians in performing an appropriate triage for children with COVID-19.
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Affiliation(s)
- Araya Satdhabudha
- Department of Pediatrics, Faculty of Medicine, Thammasat University Hospital, Thammasat University, Pathumthani, Thailand
| | - Chanapai Chaiyakulsil
- Department of Pediatrics, Faculty of Medicine, Thammasat University Hospital, Thammasat University, Pathumthani, Thailand
- * E-mail:
| | - Rattapon Uppala
- Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Watit Niyomkarn
- Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Prakarn Tovichien
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | | | - Kanokpan Ruangnapa
- Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | | | | | - Aunya Kulbun
- Department of Pediatrics, Her Royal Highness Maha Chakri Sirindhorn Medical Center, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand
| | - Rasintra Jaroenying
- Department of Pediatrics, Faculty of Medicine, Phramongkutklao Hospital, Bangkok, Thailand
- Phramongkutklao Hospital Sleep Disorder Center, Faculty of Medicine, Phramongkutklao Hospital, Bangkok, Thailand
| | - Harutai Kamalaporn
- Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Tidarat Sriboonyong
- Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | | | - Kanokkarn Sunkonkit
- Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Auchara Tangsathapornpong
- Department of Pediatrics, Faculty of Medicine, Thammasat University Hospital, Thammasat University, Pathumthani, Thailand
| | - Pornumpa Bunjoungmanee
- Department of Pediatrics, Faculty of Medicine, Thammasat University Hospital, Thammasat University, Pathumthani, Thailand
| | - Wanida Pao-in
- Department of Pediatrics, Faculty of Medicine, Thammasat University Hospital, Thammasat University, Pathumthani, Thailand
| | - Patcharapa Thaweekul
- Department of Pediatrics, Faculty of Medicine, Thammasat University Hospital, Thammasat University, Pathumthani, Thailand
| | - Pichaya Tantiyavarong
- Department of Clinical Epidemiology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
| | | | | | - Paskorn Sritipsukho
- Department of Pediatrics, Faculty of Medicine, Thammasat University Hospital, Thammasat University, Pathumthani, Thailand
- Center of Excellence in Applied Epidemiology, Thammasat University, Pathumthani, Thailand
| | - Jitladda Deerojanawong
- Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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