91例儿童新型冠状病毒肺炎确诊病例临床及流行病学特征

Clinical and epidemiological characteristics of 91 children conformed with COVID-19

目的分析儿童新型冠状病毒感染肺炎(Corona virus disease,COVID-19)确诊病例临床和流行病学特征,为制定儿童新型冠状病毒肺炎疫情防控策略和措施提供科学依据。方法采用回顾性的单一中心研究,对2020年1月25日-2月18日武汉儿童医院收治的91例新型冠状病毒肺炎确诊病例的临床资料及流行病学资料进行总结分析。结果91例COVID-19确诊患儿中男56例(61.54%)、女35例(38.46%),年龄中位数为4岁,16例(17.58%)有其他疾病或感染其他病原体;72例(79.12%)与家庭成员中有COVID-19疑似或确诊患者有过接触史。临床分型为轻症53例(58.24%),其中无症状感染者7例(7.69%)、普通型31例(34.07%)、重型6例(6.59%)、危重型1例(1.10%)。最主要的临床表现为发热(56例、61.54%)、咳嗽(51例、56.04%)、乏力(14例、15.38%),腹泻等胃肠道症状较少。11例(12.09%)患儿胸部CT影像学检查表现为斑片状或磨玻璃影,12例(13.19%)患儿表现为单侧肺炎,11例(12.09%)患儿表现为双侧肺炎。33例(36.26%)患者乳酸脱氢酶异常,32例(35.16%)患者C-反应蛋白异常,54例(59.34%)患儿降钙素原异常。新型冠状病毒首次检测核酸阳性至连续(间隔1天)两次转阴性患儿73例(80.22%),中位数为7天。结论病例以男童为主;1~12岁为高发人群;儿童患者临床症状以发热和咳嗽为主,大多数患儿为轻症;多数患儿与新型冠状病毒肺炎确诊或疑似患者有密切接触史,且多数为家庭聚集性发病。

OBJECTIVE To investigate the clinical and epidemiological characteristics of children with confirmed Corona virus disease(COVID-19)so as to provide scientific bases for development of strategies for prevention and control of the COVID-19 epidemic in children.METHODS By means of retrospective single-center study,the clinical data and epidemiological data of 91 confirmed cases of COVID-19 who were treated in Wuhan Children’s Hospital from Jan.25,2020 to Feb.18,2020 were summarized and analyzed.RESULTS Of the 91 children who were confirmed with COVID-19,56(61.54%)were male,35(38.46%)were female,the median age was 4 years old,16(17.58%)had other diseases or were infected with other pathogens;72(79.12%)had the history of contact with their family members who were suspected for COVID-19 or the confirmed cases.As for the clinical classifications,53(58.24%)were mild,7(7.69%)of whom were asymptomatic,31(34.07%)were ordinary,6(6.59%)were severe,and 1(1.10%)was critically severe.The fever(56 cases,61.54%),cough(51 cases,56.04%)and fatigue(14 cases,15.38%)were the predominant clinical manifestations,while the gastrointestinal symptoms like diarrhea were less common.The chest CT imaging examination showed that 11(12.09%)had patchy or ground glass shadow,12(13.19%)had unilateral pneumonia,and 11(12.09%)had bilateral pneumonia.33(36.26%)cases had abnormal lactate dehydrogenase,32(35.16%)cases had abnormal C-reactive protein,and 54(59.34%)cases had abnormal procalcitonin.73(80.22%)cases were tested negative for twice in a row(interval of 1 day)since the initial positive test for nucleic acid of SARS-CoV-2,with a median of 7 days.CONCLUSION The male cases are dominant among the confirmed cases.It is prevalent among the children aged between 1 and 12 years old.The fever and cough are the major clinical symptoms,and the majority are mild cases.Most of the children have the history of close contact with the patients with suspected or confirmed COVID-19,and the majority are infected due to household clustering.