Childhood pneumonia: an update in the post-COVID-19 era

Community acquired pneumonia is the leading global cause of death in childhood. Whilst COVID-19 infection does not typically cause severe illness in children the subsequent social isolation, along with changes in hygiene practices led to reduced levels of respiratory viruses and bacteria during the pandemic. This caused a significant change in the seasonality of community acquired pneumonia. Viruses are still the most common cause of community acquired pneumonia, however bacteria can cause more severe disease and it can be difficult to distinguish clinically between them. Generally, children with pneumonia can be managed at home with antipyretics, oral hydration and oral antibiotics, however a small subset need admission to hospital. Complications from pneumonia include pleural effusion, empyema, necrotizing pneumonia and pneumatocele. This article aims to direct physicians on the diagnosis and management of community acquired pneumonia and highlight the key changes since the COVID-19 pandemic.