儿童新型冠状病毒感染14例临床分析

Epidemiology,clinical and imaging features of pediatric patients with COVID-19:analysis of 14 cases

为探讨儿童新型冠状病毒感染患者的流行病学特点、临床和影像学特征,回顾分析2020年1月27日至2月12日首都医科大学附属北京地坛医院收治的14例儿童新型冠状病毒感染患者的临床和影像学资料。14例患者中,男6例,女8例,年龄6个月~9岁5个月,中位年龄3岁6个月。4例患者曾有武汉或湖北居住或旅行史,2例接触过武汉来京人员(后均确诊为新型冠状病毒肺炎患者),13例为家庭聚集性发病。潜伏期4~16 d,临床表现为发热8例,咳嗽5例,腹泻1例,无症状2例。4例患者外周血常规异常,其中1例白细胞计数升高,3例白细胞计数降低,2例淋巴细胞计数降低。3例外周血CRP轻度升高,2例血清淀粉样蛋白A(SAA)升高,10例心肌酶谱升高,3例出现肝功能损伤。13例行胸部CT检查,1例表现为肺部双肺下叶散在类圆形磨玻璃密度灶,1例表现为左肺上叶及双肺下叶胸膜下多发斑片状高密度影,1例表现为双肺纹理模糊,其余10例无异常;1例行胸片检查未见异常。14例患者中随诊2例新型冠状病毒核酸复阳,复阳后无明显症状。截至2020年3月23日,全部14例患者核酸均转为阴性。提示儿童新型冠状病毒感染患者以家庭聚集发病为主,临床主要表现为发热和咳嗽、腹泻,外周血白细胞计数多数正常,胸部CT表现较轻微,多数患者无肺炎表现。

Epidemiologic,clinical and imaging data were collected from 14 children with confirmed coronavirus disease 2019(COVID-19)admitted in Beijing Ditan Hospital from January 27,2020 to February 12,2020.There were 6 boys and 8 girls with a median age of 3.5 years(6 months-9.4 years).Four patients had a history of travel to Wuhan City or Hubei Province and 2 patients had contacted with people from Wuhan;13 patients were familial cluster of infection.The incubation period was 4 to 16 days.The clinical manifestations were fever in 8 cases,cough in 5 cases,diarrhea in 1 case;and 2 cases were asymptomatic.Four patients had abnormal peripheral blood routine,including 1 had lymphocytosis,3 had lymphocytopenia;3 patients had a slightly elevated CRP,and 3 patients had hepatic dysfunction.Thirteen patients underwent chest CT;and 1 case showed bilateral lung glass exudation,1 case showed multiple patchy high density shadows of bilateral lung.One patient underwent chest X-ray examination,which was showed no abnormal findings.The pediatric patients with COVID-19 in this series generally have a traceable epidemiological history.The clinical manifestations are fever,cough and diarrhea.Peripheral white blood cell counts were most normal.Chest CT reveals less severe changes than those in adults,most child patients show no manifestation of pneumonia.