Coronavirus Infections in Children Including COVID-19 An Overview of the Epidemiology, Clinical Features, Diagnosis, Treatment and Prevention Options in Children
Coronavirus Infections in Children Including COVID-19 An Overview of the Epidemiology, Clinical Features, Diagnosis, Treatment and Prevention Options in Children
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DOI：
10.1097/inf.0000000000002660
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发表时间：
2020-05-01
影响因子：
3.6
通讯作者：
Curtis, Nigel
中科院分区：
文献类型：
--
作者：
Zimmermann, Petra;Curtis, Nigel
冠状病毒 (CoV) 是一大类有包膜、单链、人畜共患 RNA 病毒。四种冠状病毒在人类中普遍传播：HCoV2-229E、-HKU1、-NL63 和 -OC43。然而，冠状病毒可以迅速突变和重组，从而产生可以从动物传播到人类的新型冠状病毒。新型冠状病毒严重急性呼吸综合征冠状病毒 (SARS-CoV) 于 2002 年出现，中东呼吸综合征冠状病毒 (MERS-CoV) 于 2012 年出现。2019 年新型冠状病毒 (SARS-CoV-2) 目前正在中国和其他多个国家引发严重的疾病爆发（称为 COVID-19），有可能引发全球大流行。在人类中，冠状病毒主要引起呼吸道和胃肠道症状。临床表现从普通感冒到更严重的疾病，如支气管炎、肺炎、严重急性呼吸窘迫综合征、多器官衰竭甚至死亡。与成人相比，SARS-CoV、MERS-CoV 和 SARS-CoV-2 似乎不太常见地影响儿童，并且在该年龄段引起的症状较少，疾病也较轻，并且病死率低得多。初步证据表明，儿童感染 SARS-CoV-2 的可能性与成人相同，但出现症状或出现严重症状的可能性较小。然而，儿童在传播病毒方面的重要性仍不确定。与成人相比，儿童更容易出现胃肠道症状。大多数感染 SARS 冠状病毒的儿童都会出现发烧症状，但其他新型冠状病毒则不然。许多受中东呼吸综合征冠状病毒影响的儿童没有症状。大多数感染新型冠状病毒的儿童都有记录在案的家庭接触者，通常在他们面前就出现症状。相比之下，成年人更常发生院内暴露。在这篇综述中，我们总结了人类常见循环和新型冠状病毒感染的流行病学、临床和诊断结果以及治疗和预防方案，重点关注儿童感染。
Coronaviruses (CoVs) are a large family of enveloped, single-stranded, zoonotic RNA viruses. Four CoVs commonly circulate among humans: HCoV2-229E, -HKU1, -NL63 and -OC43. However, CoVs can rapidly mutate and recombine leading to novel CoVs that can spread from animals to humans. The novel CoVs severe acute respiratory syndrome coronavirus (SARS-CoV) emerged in 2002 and Middle East respiratory syndrome coronavirus (MERS-CoV) in 2012. The 2019 novel coronavirus (SARS-CoV-2) is currently causing a severe outbreak of disease (termed COVID-19) in China and multiple other countries, threatening to cause a global pandemic. In humans, CoVs mostly cause respiratory and gastrointestinal symptoms. Clinical manifestations range from a common cold to more severe disease such as bronchitis, pneumonia, severe acute respiratory distress syndrome, multi-organ failure and even death. SARS-CoV, MERS-CoV and SARS-CoV-2 seem to less commonly affect children and to cause fewer symptoms and less severe disease in this age group compared with adults, and are associated with much lower case-fatality rates. Preliminary evidence suggests children are just as likely as adults to become infected with SARS-CoV-2 but are less likely to be symptomatic or develop severe symptoms. However, the importance of children in transmitting the virus remains uncertain. Children more often have gastrointestinal symptoms compared with adults. Most children with SARS-CoV present with fever, but this is not the case for the other novel CoVs. Many children affected by MERS-CoV are asymptomatic. The majority of children infected by novel CoVs have a documented household contact, often showing symptoms before them. In contrast, adults more often have a nosocomial exposure. In this review, we summarize epidemiologic, clinical and diagnostic findings, as well as treatment and prevention options for common circulating and novel CoVs infections in humans with a focus on infections in children.