Objectives: The treatment outcomes of pediatric obstructive sleep apnea (OSA) are affected by positive airway pressure (PAP) therapy adherence, which may be affected by the type of device used. Continuous PAP (CPAP) devices deliver a continuous and fixed air pressure level, whereas automatic PAP (APAP) devices automatically adjust the pressure to meet changing needs during sleep. The adherence, tolerance and consistency of OSA-children's use of CPAP and APAP devices were compared.Study design: One-year, observational cohort study.Methods: Twenty-seven OSA-children were enrolled. Fourteen (52%) used CPAP, and 13 (48%) used APAP. The adherence, tolerance, and consistency of the PAP usage by the two groups were compared.Results: Overall, 11 of the 27 children (41%) showed good PAP adherence. The CPAP patients averaged 4.9 h of device usage on the days used, for 60% of days, with 6 of 14 (43%) demonstrating good adherence. In comparison, the APAP patients averaged 3.2 h for 55% of days, with 5 of 13 (38%) exhibiting good adherence. The 2 groups showed no differences in their adherence, tolerance, or consistency of device usage (P values, 0.816, 0.609, and 0.720, respectively). Although the adherence of both groups improved in the second 6 months, it was without statistical significance (P values, 0.400 and 0.724). Age, sex, baseline apnea-hypopnea index, comorbidities, prescribed period, device type, mask type, and caregiver education-level were not risk factors for poor PAP adherence.Conclusions: No differences in the adherence, tolerance, or consistency of the children's use of CPAP and APAP were revealed in this small inhomogeneous cohort study with limited resources.

Background and Objective: There are only a few reports of long COVID including pulmonary function in children after COVID‐19 pneumonia. We determined the incidence of long COVID and abnormal pulmonary function in those children and identify risk factors.Methods: This cohort study enrolled children admitted with COVID‐19 pneumonia during 2021–2022. We gathered clinical characteristics during admission and at follow‐up 3 months after.Results: We determined the incidence of long COVID at 39.7% (95% confidence interval [CI]: 30.7%–49.1%). All severe pneumonia cases consistently reported persistent symptoms. Exercise intolerance, cough, and fatigue were the three most common persistent symptoms in 26 (22.4%), 21 (18.1%), and 18 (15.5%) of the patients, respectively. At the follow‐up, 21 cases (18.1%) demonstrated persistent abnormal chest radiographs. Three cases (6.9%) demonstrated restrictive ventilatory defects. Among those, one case (2.3%) demonstrated concomitant diffusion defect. Three cases (6.0%) demonstrated exercise‐induced hypoxemia after the 6‐minute walk test. Comparing spirometry variables between children with long COVID and without revealed significant difference of FEF25‐75 (z score) between two groups. Age [adjusted OR (95% CI): 1.13 (1.05–1.22), p value 0.002], allergic diseases [adjusted OR (95% CI): 4.05 (1.36–12.06), p value 0.012], and living in polluted areas [adjusted OR (95% CI): 2.73 (1.18–6.33), p value 0.019] were significantly associated with long COVID.Conclusion: A significant percentage of children developed long COVID after COVID‐19 pneumonia. We should give additional attention to those who have exercise intolerance, chronic cough, or fatigue, especially older children, severe cases, children with allergic diseases, and those living in polluted areas.

Objectives: Different pathophysiological mechanisms and the distribution of respiratory events among rapid eye movement (REM) and non-rapid eye movement (NREM) sleep modulate the effect of obstructive sleep apnea (OSA). We aimed to study the prevalence and risk factors for REM-related OSA in children.Study Design: Retrospective, cross-sectional study.Methods: We recruited 366 children with OSA confirmed by polysomnography (PSG) over a 5-year period. REM-related OSA is defined by an obstructive apnea-hypopnea index (OAHI) in the REM sleep ≥2× than during NREM sleep.Results: The prevalence of REM-related OSA in children was 50.3%. Children with REM-related OSA were more likely to be female (P = 0.042), and had lower prevalence of adenotonsillar hypertrophy (P = 0.043) compared with children with other OSA subtypes. Children with REM-related OSA slept longer in the supine position (P = 0.003), had shorter duration of NREM1 sleep (P = 0.018), lower nadir SpO₂ (P = 0.005), and a higher oxygen desaturation index 3% (ODI3%) (P = 0.014), and lower arousal index (P = 0.034) compared with other OSA subtypes. Female gender and supine sleep was the independent risk factors for REM-related OSA.Conclusion: The prevalence of REM-related OSA was 50.3%. OAHI_REM should be considered as an important parameter in future clinical research studies done in children with OSA.

Mycoplasma pneumoniae (M. pneumoniae) is a common pathogen that causes community-acquired pneumonia in children. The clinical presentation of this pathogen can range from mild self-limiting illness to severe and refractory cases. Complications may occur, such as necrotizing pneumonia and respiratory failure. Extrapulmonary complications, including encephalitis, myocarditis, nephritis, hepatitis, or even multiple organ failure, can also arise. In this editorial, we dis cuss the clinical implications of the significant findings from the article "Serum inflammatory markers in children with M. pneumoniae pneumonia and their predictive value for mycoplasma severity" published by Wang et al. They reported that measuring lactic dehydrogenase, interleukin-6 levels, and D-dimer effectively predicts refractory M. pneumoniae pneumonia cases.

This editorial explores the clinical implications of organizing pneumonia (OP) secondary to pulmonary tuberculosis, as presented in a recent case report. OP is a rare condition characterized by inflammation in the alveoli, which spreads to alveolar ducts and terminal bronchioles, usually after lung injuries caused by infections or other factors. OP is classified into cryptogenic (idiopathic) and secondary forms, the latter arising after infections, connective tissue diseases, tumors, or treatments like drugs and radiotherapy. Secondary OP may be triggered by infections caused by bacteria, viruses, fungi, mycobacteria, or parasites. Key diagnostic features include subacute onset of nonspecific respiratory symptoms such as dry cough, chest pain, and exertional dyspnea. Imaging with computed tomography scans typically reveals three patterns: (1) Bilateral subpleural consolidation; (2) Nodular consolidation; and (3) A reticular pattern. Bronchoscopy with bronchoalveolar lavage helps exclude other causes. Standard treatment consists of corticosteroid therapy tapered over 6 months to 12 months. This editorial highlights clinical and diagnostic strategies to ensure timely and effective patient care.

Background: Few studies have explored the polysomnographic features of children with obesity.Purpose: This study aimed to explore the demographic and polysomnographic features of obese children and determine whether body mass index (BMI) could predict severe obstructive sleep apnea (OSA).Methods: This cross-sectional study recruited obese children who underwent diagnostic polysomnography between January 2019 and March 2022. We explored demographic and anthropometric measures as well as polysomnographic abnormalities among them. We used receiver operating characteristic curves and logistic regression analyses to determine the optimal cutoff values of anthropometric variables for predicting severe OSA.Results: A total of 132 children with obesity (76.5% male; mean age, 12.5±3.2 years) were included. Severe OSA was identified in 64 children (48.5%). Desaturation was observed in 59.8%, while 23.5% had hyperarousal, 20.5% had sleep-related hypoventilation, 60.6% had positional OSA, 40.2% had rapid eye movement-related OSA, and 5.0% had obesity hypoventilation syndrome. Among them, BMI (odds ratio [OR], 1.11; 95% confidence interval [CI], 1.05–1.17; P<0.001), neck circumference (OR, 1.15; 95% CI, 1.07–1.25; P<0.001), and waist circumference (OR, 1.04; 95% CI, 1.02– 1.07; P=0.001) were significantly associated with severe OSA. These findings suggest a cutoff BMI for predicting severe OSA of greater than 29.2 kg/m2 with 81.3% sensitivity and 48.5% specificity.Conclusion: Severe OSA is common in children with obesity; thus, we recommend screening children with obesity and a BMI greater than 29.2 kg/m2 for severe OSA.