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儿童 COVID-19 感染的特征:来自两个意大利儿科研究网络的早期发现。

Characteristic of COVID-19 infection in pediatric patients: early findings from two Italian Pediatric Research Networks.

机构信息

Department of Emergency Medicine and Trauma Center, Meyer University Children's Hospital, Florence, Italy.

Department of Pediatrics, Community Pediatrics, Ravenna, Italy.

出版信息

Eur J Pediatr. 2020 Aug;179(8):1315-1323. doi: 10.1007/s00431-020-03683-8. Epub 2020 Jun 3.

DOI:10.1007/s00431-020-03683-8
PMID:32495147
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7269687/
Abstract

Detailed data on clinical presentations and outcomes of children with COVID-19 in Europe are still lacking. In this descriptive study, we report on 130 children with confirmed COVID-19 diagnosed by 28 centers (mostly hospitals), in 10 regions in Italy, during the first months of the pandemic. Among these, 67 (51.5%) had a relative with COVID-19 while 34 (26.2%) had comorbidities, with the most frequent being respiratory, cardiac, or neuromuscular chronic diseases. Overall, 98 (75.4%) had an asymptomatic or mild disease, 11 (8.5%) had moderate disease, 11 (8.5%) had a severe disease, and 9 (6.9%) had a critical presentation with infants below 6 months having significantly increased risk of critical disease severity (OR 5.6, 95% CI 1.3 to 29.1). Seventy-five (57.7%) children were hospitalized, 15 (11.5%) needed some respiratory support, and nine (6.9%) were treated in an intensive care unit. All recovered.Conclusion:This descriptive case series of children with COVID-19, mostly encompassing of cases enrolled at hospital level, suggest that COVID-19 may have a non-negligible rate of severe presentations in selected pediatric populations with a relatively high rates of comorbidities. More studies are needed to further understand the presentation and outcomes of children with COVID-19 in children with special needs. What is Known: • There is limited evidence on the clinical presentation and outcomes of children with COVID-19 in Europe, and almost no evidence on characteristics and risk factors of severe cases. What is New: • Among a case series of 130 children, mostly diagnosed at hospital level, and with a relatively high rate (26.2%) of comorbidities, about three-quarter had an asymptomatic or mild disease. • However, 57.7% were hospitalized, 11.5% needed some respiratory support, and 6.9% were treated in an intensive care unit.

摘要

关于欧洲儿童 COVID-19 的临床表现和结局的详细数据仍然缺乏。在这项描述性研究中,我们报告了在大流行的最初几个月里,意大利 10 个地区的 28 个中心(主要是医院)诊断出的 130 例确诊 COVID-19 的儿童。其中,67 例(51.5%)的亲属患有 COVID-19,34 例(26.2%)有合并症,最常见的是呼吸、心脏或神经肌肉慢性疾病。总体而言,98 例(75.4%)为无症状或轻症,11 例(8.5%)为中度疾病,11 例(8.5%)为重症疾病,9 例(6.9%)为危重症表现,婴儿低于 6 个月的患者患有危重症的风险显著增加(OR 5.6,95%CI 1.3 至 29.1)。75 例(57.7%)儿童住院,15 例(11.5%)需要一些呼吸支持,9 例(6.9%)在重症监护病房接受治疗。所有患者均康复。

结论

这项针对 COVID-19 儿童的描述性病例系列研究,主要纳入了在医院水平登记的病例,表明 COVID-19 在某些儿科人群中可能有不容忽视的严重表现率,且合并症发生率相对较高。需要进一步研究以更好地了解特殊需求儿童 COVID-19 的临床表现和结局。

已知

• 关于欧洲儿童 COVID-19 的临床表现和结局的证据有限,几乎没有关于重症病例特征和危险因素的证据。

新发现

• 在一项针对 130 例儿童的病例系列研究中,大多数在医院确诊,且合并症发生率相对较高(26.2%),约四分之三的患儿为无症状或轻症。• 然而,57.7%的患儿住院,11.5%需要一些呼吸支持,6.9%的患儿在重症监护病房接受治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c93/7351815/7449e3d936c4/431_2020_3683_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c93/7351815/7449e3d936c4/431_2020_3683_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c93/7351815/7449e3d936c4/431_2020_3683_Fig1_HTML.jpg

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