24例儿童感染新型冠状病毒印度株的流行病学及临床特征

Epidemiological and clinical characteristics of 24 children infected with India strain of Novel Coronavirus

目的通过病例分析总结新型冠状病毒印度变异株(B.1.617)儿童感染病例的流行病学和临床特征。方法选取2021年5月21日~2021年6月8日广州医科大学附属市八医院隔离病区接收的24例16岁以下的COVID-19印度变异株儿童患者作为研究对象,总结并分析各病例的流行病学特点、临床症状、血液学检验结果及CT影像学特征。结果年龄<7岁的患儿多为无症状感染者,青少年及学龄期儿童的感染症状以呼吸道感染为主。动态检测血常规、CRP、PCT、IL-6,白细胞在疾病早期多为正常,极少部分病例淋巴细胞绝对值偏低,C-反应蛋白及降钙素原未见明显升高。IL-6有不同程度升高、辅助T淋巴细胞绝对值轻度下降;除了2例年龄<2岁的患儿进行胸片检查,其它年龄组患儿均行胸部CT检查。轻型及普通型胸部CT表现为局限性斑片状影,个别可发展为双肺多发炎症改变,但未见“白肺”表现,无胸腔积液及气胸等重症个案。无症状感染6例,临床症状轻微且影像学无异常的轻型病例7例,伴有呼吸道症状、发热且影像学阳性的普通型病例11例;经对症干预治疗,24例患儿均取得符合临床预期的预后效果。结论儿童COVID-19印度变异株以普通型和轻型患者为主,预后尚可,疫苗接种及居家隔离是遏制疫情发展的有效方法。

Objective To summarize the epidemiological and clinical characteristics of children infected with novel coronavirus Indian variant(B.1.617)by case analysis.Methods From May 21,2021 to June 8,2021,24 children under 16 years old with COVID-19 Indian variant admitted to the isolation ward of the Eighth Affiliated Hospital of Guangzhou Medical University were selected as the research objects.The epidemiological characteristics,clinical symptoms,hematological test results and CT imaging characteristics of each case were summarized and analyzed.Results Most children under 7 years old were asymptomatic infected,and the main infection symptoms of adolescents and school-age children were respiratory tract infection.Dynamic detection of blood routine,CRP,PCT and IL-6 showed that white blood cells were mostly normal in the early stage of the disease,but the absolute value of lymphocytes was low in a few cases,and C-reactive protein and procalcitonin were not significantly increased.IL-6 increased to varying degrees,and the absolute value of helper T lymphocytes decreased slightly.Chest CT examination was performed in all children except 2 children aged<2 years old.Mild and common chest CT showed localized patchy opacity,and some cases could develop into multiple inflammatory changes in both lungs,but no“white lung”manifestations,pleural effusion,pneumothorax and other severe cases occurred.There were 6 cases of asymptomatic infection,7 mild cases with mild clinical symptoms and no imaging abnormalities,11 cases of common type with respiratory symptoms,fever and positive imaging,and no severe cases.After symptomatic intervention and treatment,24 children achieved the expected clinical outcome.Conclusion The Indian variant of COVID-19 in children is mainly common and mild,and the prognosis is good.Vaccination and home isolation are effective methods to curb the development of the epidemic.