20例儿童新型冠状病毒肺炎的临床特点

Clinical characteristics of twenty children with COVID-19

目的:总结儿童新型冠状病毒肺炎(COVID-19)病例的临床特点,为其诊疗提供参考。方法:收集湖北省4家医院20例住院COVID-19患儿的临床资料,分析其临床特征。结果:20例患儿中,18例(90.0%)患儿有疫区或密切接触史,其中7例(50%)全部家庭成员感染,11例(55.0%)仅父亲或母亲为确诊病例;12例(60.0%)有发热,10例(50.0%)患儿以发热为首发症状。1例为危重症感染且伴有基础疾病。7例(35.0%)患儿肺部CT表现为典型磨玻璃样改变。20例患儿咽拭子新型冠状病毒(SARS-CoV-2)检测均阳性。11例(55.0%)白细胞计数正常,1例(5.0%)危重症患儿淋巴细胞计数进行性下降、淋巴细胞亚群均明显降低。结论:儿童以家庭聚集性感染为主,家庭内密切接触是儿童感染的主要方式;发热是最常见的症状或首发症状。对于合并基础疾病患儿,T淋巴细胞持续降低,往往提示病情危重。

Objective: To investigate the characteristics of disease transmission, diagnosis, and treatment of COVID-19 in children. Methods: We retrospectively studied 20 children with COVID-19 from 4 medical centers in Hubei, China. Results: Among the 20 children, 18(90. 0%) were contaminated by close contact and characterized by family clustering. Seven cases(35. 0%) had all family members infected, and 11 cases(55. 0%) were confirmed by either of the parents infected. Twelve cases(60. 0%) had fever, which was the primary symptom in 10 cases(50. 0%). Only one child was in severe degree and combined with severe underlying disease(congenital heart disease). Seven cases(35. 0%) presented typical ground-glass opacity in CT. All patients were confirmed to be infected with SARS-CoV-2. Eleven cases(55. 0%) had normal white blood cell counts, and one case(5. 0%)with severe COVID-19 showed a continuous decline in T cells subsets. Conclusion: COVID-19 in children is transmitted by close contact and characterized by family clustering. Fever is the most common symptom or initial symptom. However, the sustained low levels of T cells and underlying diseases are risk factors for severe COVID-19 children.