Jinan Infectious Diseases Hospital, Shandong University, 22029# JingShi Road, Jinan, 250012, China.
Department of Infectious Diseases, Rizhao People's Hospital, Rizhao, China.
Infection. 2020 Jun;48(3):445-452. doi: 10.1007/s15010-020-01427-2. Epub 2020 Apr 16.
The COVID-19 outbreak spread in China and is a threat to the world. We reported on the epidemiological, clinical, laboratory, and radiological characteristics of children cases to help health workers better understand and provide timely diagnosis and treatment.
Retrospectively, two research centers' case series of 67 consecutive hospitalized cases including 53 adult and 14 children cases with COVID-19 between 23 Jan 2020 and 15 Feb 2020 from Jinan and Rizhao were enrolled in this study. Epidemiological, clinical, laboratory, and radiological characteristics of children and adults were analyzed and compared.
Most cases in children were mild (21.4%) and conventional cases (78.6%), with mild clinical signs and symptoms, and all cases were of family clusters. Fever (35.7%) and dry cough (21.4%) were described as clinical manifestations in children cases. Dry cough and phlegm were not the most common symptoms in children compared with adults (p = 0.03). In the early stages of the disease, lymphocyte counts did not significantly decline but neutrophils count did in children compared with adults (p = 0.02). There was a lower level of CRP (p = 0.00) in children compared with adults. There were 8 (57.1%) asymptomatic cases and 6 (42.9%) symptomatic cases among the 14 children cases. The age of asymptomatic patients was younger than that of symptomatic patients (p = 0.03). Even among asymptomatic patients, 5 (62.5%) cases had lung injuries including 3 (60%) cases with bilateral involvement, which was not different compared with that of symptomatic cases (p = 0.58, p = 0.74).
The clinical symptoms of children are mild, there is substantial lung injury even among children, but that there is less clinical disease, perhaps because of a less pronounced inflammatory response, and that the occurrence of this pattern appears to inversely correlate with age.
COVID-19 在中国蔓延，对世界构成威胁。我们报告了儿童病例的流行病学、临床、实验室和影像学特征，以帮助卫生工作者更好地理解并提供及时的诊断和治疗。
回顾性分析 2020 年 1 月 23 日至 2 月 15 日期间来自济南和日照的 2 个研究中心连续收治的 67 例住院 COVID-19 患者，包括 53 例成人和 14 例儿童患者，纳入本研究。分析并比较了儿童和成人的流行病学、临床、实验室和影像学特征。
大多数儿童患者为轻症（21.4%）和普通型（78.6%），临床表现较轻，均为家庭聚集性发病。发热（35.7%）和干咳（21.4%）为儿童患者的临床表现。与成人相比，干咳和咳痰并非儿童最常见的症状（p=0.03）。疾病早期，儿童的淋巴细胞计数无明显下降，但中性粒细胞计数下降（p=0.02）。与成人相比，儿童的 CRP 水平较低（p=0.00）。14 例儿童中有 8 例（57.1%）为无症状，6 例（42.9%）为有症状。无症状患者的年龄小于有症状患者（p=0.03）。即使是无症状患者，也有 5 例（62.5%）有肺部损伤，包括 3 例（60%）双侧受累，与有症状患者无差异（p=0.58，p=0.74）。
儿童的临床症状较轻，即使在儿童中也存在大量肺部损伤，但临床疾病较少，可能是由于炎症反应较轻，而且这种模式的发生似乎与年龄呈负相关。
