Coinfection and Other Clinical Characteristics of COVID-19 in Children
Coinfection and Other Clinical Characteristics of COVID-19 in Children
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DOI：
10.1542/peds.2020-0961
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发表时间：
2020-07-01
期刊：
影响因子：
8
通讯作者：
Xing, Quansheng
中科院分区：
文献类型：
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作者：
Wu, Qin;Xing, Yuhan;Xing, Quansheng
儿童COVID-19患者表现出与成人不同的症状，容易合并感染;在呼吸道标本显示阴性结果后，发现持续的粪便病毒RNA脱落。研究背景和意义：严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）是一种新发现的主要通过飞沫传播的病原体。大多数已发表的研究都集中在2019年冠状病毒病（COVID-19）的成人患者身上，但有关儿科患者的数据有限。方法：回顾性分析2010年1月至2011年12月收治的实验室确诊的COVID-19患儿的基本资料、流行病学史、临床表现、实验室和影像学检查、治疗、转归和随访结果。在流行病学资料完整的68例病例中，65例（65/68; 95.59%）为成人家庭接触者。44例（59.46%）有症状者起病时以咳嗽（32.43%）、发热（27.03%）为主要症状。白细胞计数异常23例（31.08%），淋巴细胞计数异常10例（13.51%）。有常见呼吸道病原体核酸检测结果的34例（45.95%）患者中，有19例（51.35%）显示与SARS-CoV-2以外的其他病原体合并感染。10例（13.51%）患儿粪便标本进行实时逆转录聚合酶链反应分析，其中8例显示SARS-CoV-2 RNA长期存在。结论：小儿COVID-19患者具有与成人患者不同的流行病学、临床和放射学特征。近一半的受感染儿童与其他常见呼吸道病原体合并感染。儿科患者在恢复期出现长时间的SARS-CoV-2 RNA粪便脱落并不罕见。
Pediatric patients with COVID-19 presented with symptoms distinct from adults and were susceptible to coinfection; persistent fecal shedding of viral RNA was found after respiratory specimens revealed negative results. BACKGROUND AND OBJECTIVES:Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a newly identified pathogen that mainly spreads by droplets. Most published studies have been focused on adult patients with coronavirus disease 2019 (COVID-19), but data concerning pediatric patients are limited. In this study, we aimed to determine epidemiological characteristics and clinical features of pediatric patients with COVID-19.METHODS:We reviewed and analyzed data on pediatric patients with laboratory-confirmed COVID-19, including basic information, epidemiological history, clinical manifestations, laboratory and radiologic findings, treatment, outcome, and follow-up results.RESULTS:A total of 74 pediatric patients with COVID-19 were included in this study. Of the 68 case patients whose epidemiological data were complete, 65 (65 of 68; 95.59%) were household contacts of adults. Cough (32.43%) and fever (27.03%) were the predominant symptoms of 44 (59.46%) symptomatic patients at onset of the illness. Abnormalities in leukocyte count were found in 23 (31.08%) children, and 10 (13.51%) children presented with abnormal lymphocyte count. Of the 34 (45.95%) patients who had nucleic acid testing results for common respiratory pathogens, 19 (51.35%) showed coinfection with other pathogens other than SARS-CoV-2. Ten (13.51%) children had real-time reverse transcription polymerase chain reaction analysis for fecal specimens, and 8 of them showed prolonged existence of SARS-CoV-2 RNA.CONCLUSIONS:Pediatric patients with COVID-19 presented with distinct epidemiological, clinical, and radiologic characteristics from adult patients. Nearly one-half of the infected children had coinfection with other common respiratory pathogens. It is not uncommon for pediatric patients to have prolonged fecal shedding of SARS-CoV-2 RNA during the convalescent phase.