The purpose of this study is to understand children's clinical characteristics with
pertussis and analyze risk factors on critical
pertussis patients. Demographic data from patients with
pertussis at Children's Hospital affiliated to the Capital Institute of Pediatrics between March 2011 and December 2018 were collected. We retrospectively gathered more information with the positive exposure, vaccination,
antibiotic usage before diagnosis, clinical manifestation, laboratory tests,
therapy, and complications for hospitalized children. We divided the patients into severe and non-severe groups, comparing related factors and clinical characteristics among each group. In particular, we summarize the clinical features of the severe patients before aggravation. A total of 967
pertussis cases were diagnosed, of which 227 were hospitalized. The onset age younger than 3 months old accounted for the highest proportion, and 126 patients received hospitalization. For those patients, the incidence of post-tussive
vomiting, paroxysmal
cyanosis, post-tussive heart rate decrease,
hypoxemia, severe
pneumonia, and
mechanical ventilation was significantly higher than that in the ≥ 3-month-old group (p < 0.05). Among 227 hospitalized patients, 54 suffered from severe
pertussis. Risk factors for severe patients included early age of onset, pathogen exposure, and unvaccinated status.
Cough paroxysms, post-tussive
vomiting, paroxysmal
cyanosis, facial
flushing/
cyanosis/
fever during
cough, increased WBC, and chest X-ray revealing
pneumonia/consolidation/
atelectasis were important indications of severe
pertussis. Unvaccinated status was an independent risk factor for severe
pertussis. The most vulnerable population was infants < 3 months old to
pertussis, and may be on the severe end of the disease. Pediatricians must detect and treat severe cases promptly and recommend timely vaccination for all eligible children.