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儿童 COVID-19 感染的临床和 CT 特征:与成人的不同点。

Clinical and CT features in pediatric patients with COVID-19 infection: Different points from adults.

机构信息

Department of Imaging Center, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.

出版信息

Pediatr Pulmonol. 2020 May;55(5):1169-1174. doi: 10.1002/ppul.24718. Epub 2020 Mar 5.

Abstract

PURPOSE

To discuss the different characteristics of clinical, laboratory, and chest computed tomography (CT) in pediatric patients from adults with 2019 novel coronavirus (COVID-19) infection.

METHODS

The clinical, laboratory, and chest CT features of 20 pediatric inpatients with COVID-19 infection confirmed by pharyngeal swab COVID-19 nucleic acid test were retrospectively analyzed during 23 January and 8 February 2020. The clinical and laboratory information was obtained from inpatient records. All the patients were undergone chest CT in our hospital.

RESULTS

Thirteen pediatric patients (13/20, 65%) had an identified history of close contact with COVID-19 diagnosed family members. Fever (12/20, 60%) and cough (13/20, 65%) were the most common symptoms. For laboratory findings, procalcitonin elevation (16/20, 80%) should be pay attention to, which is not common in adults. Coinfection (8/20, 40%) is common in pediatric patients. A total of 6 patients presented with unilateral pulmonary lesions (6/20, 30%), 10 with bilateral pulmonary lesions (10/20, 50%), and 4 cases showed no abnormality on chest CT (4/20, 20%). Consolidation with surrounding halo sign was observed in 10 patients (10/20, 50%), ground-glass opacities were observed in 12 patients (12/20, 60%), fine mesh shadow was observed in 4 patients (4/20, 20%), and tiny nodules were observed in 3 patients (3/20, 15%).

CONCLUSION

Procalcitonin elevation and consolidation with surrounding halo signs were common in pediatric patients which were different from adults. It is suggested that underlying coinfection may be more common in pediatrics, and the consolidation with surrounding halo sign which is considered as a typical sign in pediatric patients.

摘要

目的

讨论儿童与成人 2019 年新型冠状病毒(COVID-19)感染患者的临床、实验室和胸部计算机断层扫描(CT)特征的不同之处。

方法

回顾性分析 2020 年 1 月 23 日至 2 月 8 日期间经咽拭子 COVID-19 核酸检测确诊的 20 例儿童住院患者的临床、实验室和胸部 CT 特征。临床和实验室信息取自住院记录。所有患者均在我院行胸部 CT。

结果

13 例(13/20,65%)患儿有与 COVID-19 确诊家庭成员的密切接触史。发热(12/20,60%)和咳嗽(13/20,65%)是最常见的症状。实验室检查中,降钙素原升高(16/20,80%)应引起重视,这在成人中并不常见。合并感染(8/20,40%)在儿科患者中很常见。6 例患儿表现为单侧肺部病变(6/20,30%),10 例患儿表现为双侧肺部病变(10/20,50%),4 例患儿胸部 CT 未见异常(4/20,20%)。10 例患儿(10/20,50%)表现为合并周围晕征的实变,12 例患儿(12/20,60%)表现为磨玻璃影,4 例患儿(4/20,20%)表现为细网格影,3 例患儿(3/20,15%)表现为小结节。

结论

降钙素原升高和合并周围晕征在儿科患者中较为常见,与成人不同。提示基础合并感染在儿科更为常见,而合并周围晕征可能是儿科患者的典型表现。

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