Early Experience of COVID-19 in a US Children's Hospital
Early Experience of COVID-19 in a US Children's Hospital
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DOI：
10.1542/peds.2020-003186
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发表时间：
2020-10-01
期刊：
影响因子：
8
通讯作者：
Rubin, Lorry G.
中科院分区：
文献类型：
--
作者：
Kainth, Mundeep K.;Goenka, Pratichi K.;Rubin, Lorry G.
目的：我们旨在描述2019年冠状病毒病（COVID-19）儿科住院患者的人口统计学、临床表现、住院病程和严重程度，重点关注健康、免疫功能低下和慢性疾病儿童。方法：我们对在Northwell Health的Steven and Alexandra Cohen儿童医疗中心住院的年龄小于22岁的COVID-19感染儿童进行了一项单中心回顾性队列研究。病例来自发热和/或有呼吸道症状的患者，他们接受了基于核酸扩增的严重急性呼吸综合征冠状病毒2检测。结果：共发现65例患者。中位年龄为10.3岁（四分位数范围为1.4个月至16.3岁），其中48%的患者年龄大于12岁，29%的患者年龄小于60天。86%的患者出现发热，60%的患者出现下呼吸道症状或体征，62%的患者出现胃肠道症状。35%的患者需要ICU护理。与轻度和中度疾病相比，重症患者白细胞计数升高（P= 0.0027）， c反应蛋白水平升高（P= 0.0192）。34%的患者需要呼吸支持。60天以下婴儿的严重程度最低，慢性病儿童的严重程度最高；79%的免疫功能低下儿童患有轻度疾病。据报道有一人死亡。结论：在因COVID-19住院的儿童中，大多数年龄小于60天或大于12岁。儿童可能有严重感染，需要重症监护支持。免疫功能低下患儿的临床病程并不比其他患儿严重。白细胞计数和c反应蛋白水平升高与疾病严重程度增加有关。在本文中，我们分享了健康、免疫功能低下和慢性儿科住院患者COVID-19的人口统计数据、临床表现、住院过程和严重程度。
OBJECTIVES: We aim to describe the demographics, clinical presentation, hospital course, and severity of pediatric inpatients with coronavirus disease 2019 (COVID-19), with an emphasis on healthy, immunocompromised, and chronically ill children. METHODS: We conducted a single-center retrospective cohort study of hospitalized children aged younger than 22 years with COVID-19 infection at Steven and Alexandra Cohen Children's Medical Center at Northwell Health. Cases were identified from patients with fever and/or respiratory symptoms who underwent a nucleic acid amplification-based test for severe acute respiratory syndrome coronavirus 2. RESULTS: Sixty-five patients were identified. The median age was 10.3 years (interquartile range, 1.4 months to 16.3 years), with 48% of patients older than 12 years and 29% of patients younger than 60 days of age. Fever was present in 86% of patients, lower respiratory symptoms or signs in 60%, and gastrointestinal symptoms in 62%. Thirty-five percent of patients required ICU care. The white blood cell count was elevated in severe disease (P= .0027), as was the C-reactive protein level (P= .0192), compared with mild and moderate disease. Respiratory support was required in 34% of patients. Severity was lowest in infants younger than 60 days of age and highest in chronically ill children; 79% of immunocompromised children had mild disease. One death was reported. CONCLUSIONS: Among children who are hospitalized for COVID-19, most are younger than 60 days or older than 12 years of age. Children may have severe infection requiring intensive care support. The clinical course of immunocompromised patients was not more severe than that of other children. Elevated white blood cell count and C-reactive protein level are associated with greater illness severity.In this article we share the demographics, clinical presentation, hospital course, and severity of healthy, immunocompromised, and chronically ill pediatric inpatients with COVID-19.