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儿童 2019 冠状病毒病:在全球大流行期间的惊人发现。

Coronavirus disease 2019 in children: Surprising findings in the midst of a global pandemic.

出版信息

Can Fam Physician. 2020 May;66(5):332-334.

Abstract

Coronavirus disease 2019 (COVID-19) is affecting millions of people worldwide. It seems that it affects mostly adults older than 40 years of age, and the death rate is highest for older individuals in the population. What should I tell parents worried about their children contracting the coronavirus (SARS-CoV-2) causing COVID-19, and what symptoms should I look for to determine if there is a need to test for the virus? The COVID-19 global pandemic affects all ages. Severe respiratory manifestations have been the mainstay of illness in adults, with what seems to be rapid deterioration necessitating mechanical ventilation. Only 5% of those tested and found to have COVID-19 have been younger than 19 years, possibly owing to limited testing, as the symptoms in children are usually mild. Symptoms in children include fever, dry cough, rhinorrhea, sore throat, and fatigue, and in 10% diarrhea or vomiting. Rarely dyspnea or hypoxemia were also described. Blood tests and imaging have been shown to be of little value in children and should only be ordered for those in whom you would normally order these investigations for viral-like illness. No specific therapy is available and supportive care with rest, fluids, and antipyretics for children is the recommended approach. Ibuprofen or acetaminophen for fever and pain can be given. Antiviral and immunomodulatory treatment is not recommended at this time for otherwise healthy children, and corticosteroids should also not be used. Children with immunocompromised states should be isolated and avoid contact with others.

摘要

2019 年冠状病毒病(COVID-19)正在影响全球数百万人。它似乎主要影响 40 岁以上的成年人,并且该病毒的死亡率在人群中最高的是老年人。我应该告诉那些担心孩子感染导致 COVID-19 的冠状病毒(SARS-CoV-2)的父母什么,我应该寻找哪些症状来确定是否需要对该病毒进行检测?COVID-19 大流行影响所有年龄段。严重的呼吸道表现一直是成人患病的主要特征,似乎病情迅速恶化,需要机械通气。在接受检测并发现 COVID-19 的人中,只有 5%年龄小于 19 岁,这可能是由于检测有限,因为儿童的症状通常较轻。儿童的症状包括发热、干咳、流涕、喉咙痛和疲劳,10%的儿童还会腹泻或呕吐。也很少有呼吸困难或低氧血症的描述。在儿童中,血液检查和影像学检查的价值有限,仅在您通常会对病毒性疾病进行这些检查的情况下进行。目前尚无特定的治疗方法,建议对休息、补液和退热的儿童进行支持性治疗。可以给发热和疼痛的儿童服用布洛芬或对乙酰氨基酚。目前不建议对健康的儿童使用抗病毒和免疫调节治疗,也不应使用皮质类固醇。免疫功能低下的儿童应隔离并避免与他人接触。

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