The Coronavirus Disease 2019 (COVID-19) in Children: A Study in an Iranian Children's Referral Hospital
The Coronavirus Disease 2019 (COVID-19) in Children: A Study in an Iranian Children's Referral Hospital
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DOI：
10.2147/idr.s259064
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发表时间：
2020-01-01
影响因子：
3.9
通讯作者：
Mamishi, Setareh
中科院分区：
文献类型：
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作者：
Mahmoudi, Shima;Mehdizadeh, Mehrzad;Mamishi, Setareh
背景资料：尽管2019冠状病毒病（COVID-19）在全球范围内传播，但COVID-19感染的流行病学和临床模式仍不清楚，尤其是在儿童中。在这项研究中，我们探讨了儿童COVID-19患者的流行病学特征、临床模式、实验室和影像学表现。材料和方法：2020年3月7日至3月30日，共有35名患者通过实验室病毒核酸检测（RT-PCR）确诊为COVID-19感染用咽拭子样本或与COVID-19相符的典型胸部CT表现进行检测，此外还有家庭成员中疑似或确诊的SARS-CoV-2的密切接触史。记录的信息包括人口统计学数据，病史，暴露史，潜在的合并症，症状，体征，实验室检查结果和放射学评估，疾病的严重程度，治疗和mortality.Results：患者的中位年龄为7.5岁（IQR=4-11，范围=4个月至15岁）。其中63%为男性。80%的患者出现咳嗽，其次是发热（77%）、恶心或呕吐（29%）、腹泻（26%）、呼吸急促（29%）、头痛（20%）和肌痛（14%）。43%的患者出现淋巴细胞减少症，9%出现血小板减少症，8%出现中性粒细胞减少症，26%出现白细胞减少症。我们报告了40%的住院患者中有严重肺炎，18例（51%）有基础疾病。在35例患者中，11例（31%）有阳性RT-PCR结果。24例患者（69%）的胸部CT图像提示COVID-19，而他们的咽拭子样本的RT-PCR检测结果为阴性。结论：本研究显示了与以往儿童报告相比的儿科临床表现。由于观察到RT-PCR检测的假阴性率很高，因此通过CT早期发现COVID-19感染的儿童有助于合理管理和早期治疗。
Background: Despite the worldwide spread of the coronavirus disease 2019 (COVID-19), the epidemiological and clinical patterns of the COVID-19 infection remain largely unclear, particularly among children. In this study, we explored the epidemiological characteristics, clinical patterns, and laboratory and imaging findings of pediatric patients with COVID-19.Materials and Methods: From March 7 to March 30, 2020, there were a total of 35 patients who had confirmed COVID-19 infection by laboratory virus nucleic acid test (RT-PCR) assay with throat swab samples or typical chest CT manifestation compatible with COVID-19, in addition to a history of close contact with suspected or confirmed SARS-CoV-2 in family members. Information recorded included demographic data, medical history, exposure history, underlying comorbidities, symptoms, signs, laboratory findings and radiologic assessments, severity of disease, treatment, and mortality.Results: The median age of the patients was 7.5 years (IQR=4-11, range=4 months to 15 years). A total of 63% were male. Cough was present in 80% of the patients, followed by fever (77%), nausea or vomiting (29%), diarrhea (26%), shortness of breath (29%), headache (20%), and myalgia (14%). Lymphopenia was present in 43% of the patients, thrombocytopenia in 9%, neutopenia in 8%, and leucopenia in 26%. We reported severe pneumonia in 40% of the hospitalized patients and 18 (51%) had underlying diseases. Of 35 patients, 11 had positive RT-PCR results (31%). The chest CT images of 24 patients (69%) suggested COVID-19, while their RT-PCR assays from throat swab samples were negative.Conclusion: This study demonstrates different clinical findings of pediatrics compared to the previous reports of children. Since a high rate of false negative RT-PCR test was observed, early detection of children with COVID-19 infection by CT is conducive to reasonable management and early treatment.