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儿童新型冠状病毒肺炎诊疗建议(第二版)

[Diagnosis and treatment recommendation for pediatric COVID-19 (the second edition)].

作者信息

Chen Zhimin, Fu Junfen, Shu Qiang, Wang Wei, Chen Yinghu, Hua Chunzhen, Li Fubang, Lin Ru, Tang Lanfang, Wang Tianlin, Wang Yingshuo, Xu Weize, Yang Zihao, Ye Sheng, Yuan Tianming, Zhang Chenmei, Zhang Yuanyuan

机构信息

Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou 310052, China.

出版信息

Zhejiang Da Xue Xue Bao Yi Xue Ban. 2020 May 25;49(2):139-146. doi: 10.3785/j.issn.1008-9292.2020.02.01.

Abstract

The coronavirus disease 2019 (COVID-19) has caused a global pandemic. All people including children are generally susceptible to COVID-19, but the condition is relatively mild for children. The diagnosis of COVID-19 is largely based on the epidemiological evidence and clinical manifestations, and confirmed by positive detection of virus nucleic acid in respiratory samples. The main symptoms of COVID-19 in children are fever and cough; the total number of white blood cell count is usually normal or decreased; the chest imaging is characterized by interstitial pneumonia, which is similar to other respiratory virus infections and infections. Early identification, early isolation, early diagnosis and early treatment are important for clinical management. The treatment of mild or moderate type of child COVID-19 is mainly symptomatic. For severe and critical ill cases, the oxygen therapy, antiviral drugs, antibacterial drugs, glucocorticoids, mechanical ventilation or even extracorporeal membrane oxygenation (ECMO) may be adopted, and the treatment plan should be adjusted timely through multi-disciplinary cooperation.

摘要

2019冠状病毒病(COVID-19)已引发全球大流行。包括儿童在内的所有人普遍对COVID-19易感,但儿童病情相对较轻。COVID-19的诊断主要基于流行病学证据和临床表现,并通过呼吸道样本中病毒核酸检测呈阳性得以确诊。儿童COVID-19的主要症状为发热和咳嗽;白细胞计数总数通常正常或降低;胸部影像学表现为间质性肺炎,这与其他呼吸道病毒感染及感染相似。早期识别、早期隔离、早期诊断和早期治疗对临床管理至关重要。儿童COVID-19轻症或中症类型的治疗主要是对症治疗。对于重症和危重症病例,可采用氧疗、抗病毒药物、抗菌药物、糖皮质激素、机械通气甚至体外膜肺氧合(ECMO),并应通过多学科合作及时调整治疗方案。

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