江西地区23例18岁以下儿童2019冠状病毒病临床分析

目的研究18岁以下儿童2019冠状病毒病(COVID-19)的临床特征。方法回顾性分析江西地区2020年1月21日至2020年2月29日确诊的23例儿童COVID-19的临床资料(患儿年龄为3个月至17岁8个月)。结果23例COVID-19患儿中,17例为家庭聚集性发病;无症状感染3例(13%),轻型6例(26%),普通型14例(61%)。发热16例(70%),咳嗽11例(48%),发热伴咳嗽8例(35%),肺部湿啰音8例(35%)。从发病或首次新型冠状病毒SARS-CoV-2核酸阳性至核酸转阴时间为6~24 d(中位数12 d)。3例白细胞总数降低,2例淋巴细胞下降,2例C反应蛋白增高,2例D-二聚体增高。12例肺部CT异常,其中肺内片状磨玻璃影9例。23例均应用了抗病毒治疗,均治愈出院。结论18岁以下儿童COVID-19多为家庭聚集性发病,临床表现、实验室检查无特异性,症状较轻,预后较好。流行病学史在18岁以下儿童COVID-19诊断中非常重要。

Clinical features of coronavirus disease 2019 in children aged <18 years in Jiangxi, China: an analysis of 23 cases

Objective To study the clinical features of coronavirus disease 2019 (COVID-19) in children aged < 18 years. Methods A retrospective analysis was performed from the medical data of 23 children, aged from 3 months to 17 years and 8 months, who were diagnosed with COVID-19 in Jiangxi, China from January 21 to February 29, 2020. Results Of the 23 children with COVID-19, 17 had family aggregation. Three children (13%) had asymptomatic infection, 6 (26%) had mild type, and 14 (61%) had common type. Among these 23 children, 16 (70%) had fever, 11 (48%) had cough, 8 (35%) had fever and cough, and 8 (35%) had wet rales in the lungs. The period from disease onset or the first nucleic acid-positive detection of SARS-CoV-2 to the virus nucleic acid negative conversion was 6-24 days (median 12 days). Of the 23 children, 3 had a reduction in total leukocyte count, 2 had a reduction in lymphocytes, 2 had an increase in C-reactive protein, and 2 had an increase in D-dimer. Abnormal pulmonary CT findings were observed in 12 children, among whom 9 had patchy ground-glass opacities in both lungs. All 23 children received antiviral therapy and were recovered. Conclusions COVID-19 in children aged < 18 years often occurs with family aggregation, with no specific clinical manifestation and laboratory examination results. Most of these children have mild symptoms and a good prognosis. Epidemiological history is of particular importance in the diagnosis of COVID-19 in children aged < 18 years.