长沙市儿童新型冠状病毒感染13例临床特征分析

Clinical features of children with SARS-CoV-2 infection:an analysis of 13 cases from Changsha,China

目的分析儿童新型冠状病毒(SARS-CoV-2)感染的临床特征。方法收集长沙市13例SARS-CoV-2感染患儿的临床资料并进行回顾性分析。结果13例患儿均为家庭聚集性发病。2例无症状感染;其余11例临床表现包括发热、咳嗽、咽部不适、腹痛、腹泻、抽搐、呕吐。临床分型包括7例轻型,5例普通型,1例重型。6例发热患儿热程中位时间为2 d。所有患儿外周血淋巴细胞计数、免疫球蛋白、CD4、CD8、IL-6等水平均在正常范围。13例患儿鼻咽拭子SARS-CoV-2核酸检测转阴的中位时间为13 d,期间3例患儿存在核酸检测假阴性现象;1例患儿鼻咽拭子SARS-CoV-2核酸检测阴性后大便核酸持续阳性12 d。6例患儿肺部CT有异常改变。所有患儿均治愈出院,出院后2周随访均正常。结论家庭内接触传播为儿童SARS-CoV-2感染的主要途径,不排除粪-口传播。儿童病例以轻型及普通型为主,未见细胞因子风暴现象,且近期预后良好,远期预后尚需继续追踪。建议对感染病例及密切接触者多次多部位采样进行核酸检测,及时阻断传播。

Objective To study the clinical features of children with severe acute respiratory syndrome coronavirus 2(SARS-Co V-2)infection.Methods A retrospective analysis was performed for the clinical data of 13 children with SARS-Co V-2 infection who hospitalized in a Changsha hospital.Results All 13 children had the disease onset due to family aggregation.Of the 13 children,2 had no symptoms,and the other 11 children had the clinical manifestations of fever,cough,pharyngeal discomfort,abdominal pain,diarrhea,convulsions,or vomiting.As for clinical typing,7 had mild type,5 had common type,and 1 had severe type.The median duration of fever was 2 days in 6 children.All 13 children had normal levels of peripheral blood lymphocyte counts,immunoglobulins,CD4,CD8,and interleukin-6.The median time to clearance of SARS-Co V-2 was 13 days in the nasopharyngeal swabs of the 13 children.Three children presented false negatives for RT-PCR of SARS-Co V-2.SARS-Co V-2 RNA remained detectable in stools for 12 days after the nasopharyngeal swab test yielded a negative result.Abnormal CT findings were observed in 6 children.All 13 children were cured and discharged and they were normal at 2 weeks after discharge.Conclusions Intra-family contact is the main transmission route of SARS-Co V-2 infection in children,and there is also a possibility of fecal-oral transmission.Mild and common types are the major clinical types in children with SARS-Co V-2 infection,and cytokine storm is not observed.Children with SARS-Co V-2 infection tend to have a good short-term prognosis,and follow-up is needed to observe their long-term prognosis.Multiple nucleic acid tests should be performed for patients with SARS-Co V-2 infection and their close contacts by multiple site sampling.