Zhang Ni, Deng Yuebi, Li Weiguo, Liu Junhong, Li Haiying, Liu Enmei, Zheng Xianlan
Outpatient Department of Liangjiang, Children's Hospital of Chongqing Medical University, Chongqing 401122, China.
National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.
Transl Pediatr. 2020 Apr;9(2):126-132. doi: 10.21037/tp.2020.03.08.
Since December 2019, a number of patients infected with COVID-19 (SARS-CoV-2) have been identified in Wuhan, Hubei, China. As the epidemic has spread, similar cases have also been found in other parts of mainland China and abroad. The main reason for this spread is the highly contagious nature of the virus and the fact that children can also become infected during its incubation period. This has made the virus a substantial challenge for the outpatient triage staff of children's hospitals outside the epidemic area of the Hubei Province. It is very important for the preview and triage personnel to accurately grasp the epidemiology of the virus and identify children's symptoms in the fever clinic.
We performed an analysis of our early preview and triage of suspected COVID-19 in 36 children presenting at fever clinics. Two specialists either excluded suspected cases or referred cases to the isolation ward for new nucleic acid testing.
All 14 children who were transferred to the isolation ward had a fever, and 71.43% of them had a cough. Their nucleic acid testing results were negative. The suspected cases and excluded suspected cases had similar epidemiology history as well as complete blood count results. With reference to the diagnostic criteria in existing pediatric guidelines, we have further improved the triage screening questionnaire for children with fever in our hospital.
According to the situation in our city and hospital, an evaluation questionnaire that is suitable for use with children in our hospital has been formulated to achieve the goals of early detection, isolation, diagnosis, and treatment. We provided an important basis for the next step in developing accurate preview and triage screening standards and appropriate guidelines for pediatric patients.
自2019年12月以来,中国湖北省武汉市发现了多例感染新型冠状病毒肺炎(SARS-CoV-2)的患者。随着疫情蔓延,中国大陆其他地区及国外也发现了类似病例。疫情传播的主要原因是该病毒具有高度传染性,且儿童在潜伏期也可被感染。这给湖北省疫区以外儿童医院的门诊分诊工作人员带来了巨大挑战。对于预检分诊人员而言,准确掌握该病毒的流行病学情况并在发热门诊识别儿童症状非常重要。
我们对36例到发热门诊就诊的疑似新型冠状病毒肺炎患儿的早期预检分诊情况进行了分析。由两名专家对疑似病例进行排除或转诊至隔离病房进行重新核酸检测。
所有转入隔离病房的14例患儿均有发热症状,其中71.43%伴有咳嗽。他们的核酸检测结果均为阴性。疑似病例和排除疑似病例的流行病学史及血常规结果相似。参照现有儿科指南中的诊断标准,我们进一步完善了我院发热儿童的分诊筛查问卷。
根据我市及我院的情况,制定了适合我院儿童使用的评估问卷,以实现早发现、早隔离、早诊断、早治疗的目标。为下一步制定准确的预检分诊筛查标准及适合儿科患者的相关指南提供了重要依据。