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[2019冠状病毒病在婴幼儿中的临床特征及胸部CT表现]

[Clinical features and chest CT findings of coronavirus disease 2019 in infants and young children].

作者信息

Zhou Yun, Yang Gen-Dong, Feng Kai, Huang Hua, Yun Yong-Xing, Mou Xin-Yan, Wang Li-Fei

机构信息

Department of Radiology, Shenzhen Third People's Hospital/National Clinical Research Center for Infectious Diseases/Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong 518100, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2020 Mar;22(3):215-220. doi: 10.7499/j.issn.1008-8830.2020.03.007.

Abstract

OBJECTIVE

To study the clinical features and chest CT findings of coronavirus disease 2019 (COVID-19) in infants and young children.

METHODS

A retrospective analysis was performed for the clinical data and chest CT images of 9 children, aged 0 to 3 years, who were diagnosed with COVID-19 by nucleic acid detection between January 20 and February 10, 2020.

RESULTS

All 9 children had an epidemiological history, and family clustering was observed for all infected children. Among the 9 children with COVID-19, 5 had no symptoms, 4 had fever, 2 had cough, and 1 had rhinorrhea. There were only symptoms of the respiratory system. Laboratory examination showed no reductions in leukocyte or lymphocyte count. Among the 9 children, 6 had an increase in lymphocyte count and 2 had an increase in leukocyte count. CT examination showed that among the 9 children, 8 had pulmonary inflammation located below the pleura or near the interlobar fissure and 3 had lesions distributed along the bronchovascular bundles. As for the morphology of the lesions, 6 had nodular lesions and 7 had patchy lesions; ground glass opacity with consolidation was observed in 6 children, among whom 3 had halo sign, and there was no typical paving stone sign.

CONCLUSIONS

Infants and young children with COVID-19 tend to have mild clinical symptoms and imaging findings not as typical as those of adults, and therefore, the diagnosis of COVID-19 should be made based on imaging findings along with epidemiological history and nucleic acid detection. Chest CT has guiding significance for the early diagnosis of asymptomatic children.

摘要

目的

研究2019冠状病毒病(COVID-19)在婴幼儿中的临床特征及胸部CT表现。

方法

对2020年1月20日至2月10日期间9例0至3岁经核酸检测确诊为COVID-19的儿童的临床资料及胸部CT图像进行回顾性分析。

结果

9例患儿均有流行病学史,所有感染患儿均观察到家庭聚集性。9例COVID-19患儿中,5例无症状,4例发热,2例咳嗽,1例流涕。仅出现呼吸系统症状。实验室检查显示白细胞及淋巴细胞计数无降低。9例患儿中,6例淋巴细胞计数升高,2例白细胞计数升高。CT检查显示,9例患儿中,8例肺部炎症位于胸膜下或叶间裂附近,3例病变沿支气管血管束分布。至于病变形态,6例有结节状病变,7例有斑片状病变;6例患儿可见磨玻璃影合并实变,其中3例有晕征,无典型铺路石征。

结论

COVID-19婴幼儿临床症状往往较轻,影像学表现不如成人典型,因此,COVID-19的诊断应结合影像学表现、流行病学史及核酸检测。胸部CT对无症状儿童的早期诊断具有指导意义。

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