Severe and fatal forms of COVID-19 in children
Severe and fatal forms of COVID-19 in children
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DOI：
10.1016/j.arcped.2020.05.010
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发表时间：
2020-07-01
影响因子：
1.8
通讯作者：
Renolleau, S.
中科院分区：
文献类型：
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作者：
Oualha, M.;Bendavid, M.;Renolleau, S.
目的：本研究的目的是描述2019年儿童新型冠状病毒病的严重形式，包括患者特征、临床、实验室和影像学发现，以及疾病管理和结果。方法：这是一项回顾性、单中心、观察性研究，在巴黎一家城市医院的儿科重症和高依赖性护理病房（PICU， HDU）进行。纳入所有因确诊或高度疑似SARS-CoV-2入院的1个月至18岁患者。结果：我们分析了27例患儿的资料。合并症（n = 19, 70%）主要是神经系统疾病（n = 7）、呼吸系统疾病（n = 4）或镰状细胞病（n = 4）。24名儿童（鼻咽拭子）SARS-CoV-2 PCR结果呈阳性。其余三名儿童进行了与COVID-19相符的胸部CT扫描。24例患者（89%）出现呼吸受累。支持性治疗包括有创机械通气（n = 9）、儿茶酚胺（n = 4）、红细胞置换（n = 4）、肾脏替代治疗（n = 1）和体外膜氧合（n = 1）。5名儿童死亡，其中3名没有既往病史。结论：本研究突出了COVID-19的临床表现和疾病进展的时间进程的广谱性，以及以合并症患者为主的儿科危及和致命病例的不可忽视的发生率。需要进一步的实验室调查来进一步分析儿童中SARS-Cov-2致病性变异性的机制。(C) 2020法国儿科学会。Elsevier Masson SAS出版。版权所有。
Objectives: The aim of this study was to describe severe forms of novel coronavirus disease 2019 in children, including patient characteristics, clinical, laboratory, and imaging findings, as well as the disease management and outcomes.Methods: This was a retrospective, single-center, observational study conducted in a pediatric intensive and high-dependency care unit (PICU, HDU) in an urban hospital in Paris. All patients, aged from 1 month to 18 years, admitted for confirmed or highly suspected SARS-CoV-2 were included.Results: We analyzed the data of 27 children. Comorbidities (n = 19, 70%) were mainly neurological (n = 7), respiratory, (n = 4), or sickle cell disease (n = 4). SARS-CoV-2 PCR results were positive in 24 children (nasopharyngeal swabs). The three remaining children had a chest CT scan consistent with COVID-19. Respiratory involvement was observed in 24 patients (89%). Supportive treatments were invasive mechanical ventilation (n = 9), catecholamine (n = 4), erythropheresis (n = 4), renal replacement therapy (n = 1), and extracorporeal membrane oxygenation (n = 1). Five children died, of whom three were without past medical history.Conclusion: This study highlighted the large spectrum of clinical presentation and time course of disease progression as well as the non-negligible occurrence of pediatric life-threatening and fatal cases of COVID-19 mostly in patients with comorbidities. Additional laboratory investigations are needed to further analyze the mechanism underlying the variability of SARS-Cov-2 pathogenicity in children. (C) 2020 French Society of Pediatrics. Published by Elsevier Masson SAS. All rights reserved.