Brunna de Paulo SANTANA, Cláudio D'ELIA, Clemax Couto SANT'ANNA, Maria de Fatima Bazhuni Pombo SANT'ANNA
Cerrahpaşa Medical Journal - 2026;50(1):1-7
Objective: To characterize the clinical, radiological, and epidemiological profile of patients hospitalized with community-acquired pneumonia (CAP), compare the characteristics of vaccinated and unvaccinated children and identify factors associated with prolonged hospitalization. Methods: A retrospective, monocentric cohort study was conducted at the Instituto de Puericultura e Pediatria Martagão Gesteira (IPPMG), a University Pediatric Hospital affiliated with the Universidade Federal do Rio de Janeiro (UFRJ), from January 2013 to December 2018. The study included children and adolescents aged 29 days to 14 years hospitalized with CAP. Data on demographics, clinical presentation, radiological findings, vaccination status, comorbidities, and hospitalization outcomes were analyzed. Bivariate and multivariate logistic regression analyses were performed to identify factors associated with prolonged hospitalization (>10 days). Results: Among 185 patients analyzed, 58.9% were male and 89.7% were under 5 years of age. Comorbidities were present in 61.5% of patients, with neurological disorders being the most frequent (22.0%). 10-valent pneumococcal conjugate vaccine (PCV10) vaccination coverage was 75.6%. Vaccinated patients had significantly higher median age (22 vs. 15 months; P = .048) and daycare attendance (32.5% vs. 7.7%; P = .012), but lower occurrence of neurological disorders (17.8% vs. 33%; P = .041) and other comorbidities (13.6% vs. 30.8%; P = .014). Alveolar consolidation was the most common radiological finding, and pleural effusion was the most frequent complication (21.9%). The median hospitalization duration was 11 days. In the multivariate analysis, neurological disorders and pleural effusion were independent predictors of prolonged hospitalization (>10 days). Conclusion: Despite high PCV10 vaccination coverage, severe CAP requiring hospitalization continues to occur, particularly in patients with underlying comorbidities. Neurological disorders and pleural effusion were significant predictors of prolonged hospitalization.
