Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
National Children's Research Centre, Dublin, Ireland.
J Pediatric Infect Dis Soc. 2020 Nov 10;9(5):523-529. doi: 10.1093/jpids/piaa074.
Understanding the prevalence and clinical presentation of coronavirus disease 2019 in pediatric patients can help healthcare providers and systems prepare and respond to this emerging pandemic.
This was a retrospective case series of patients tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) across a pediatric healthcare network, including clinical features and outcomes of those with positive test results.
Of 7256 unique children tested for SARS-CoV-2, 424 (5.8%) tested positive. Patients aged 18-21 years had the highest test positive rate (11.2%), while those aged 1-5 years had the lowest (3.9%). By race, 10.6% (226/2132) of black children tested positive vs 3.3% (117/3592) of white children. By indication for testing, 21.1% (371/1756) of patients with reported exposures or clinical symptoms tested positive vs 3.8% (53/1410) of those undergoing preprocedural or preadmission testing. Of 424 patients who tested positive for SARS-CoV-2, 182 (42.9%) had no comorbidities, 87 (20.5%) had asthma, and 55 (13.0%) were obese. Overall, 52.1% had cough, 51.2% fever, and 14.6% shortness of breath. Seventy-seven (18.2%) SARS-CoV-2-positive patients were hospitalized, of whom 24 (31.2%) required respiratory support. SARS-CoV-2-targeted antiviral therapy was given to 9 patients, and immunomodulatory therapy to 18 patients. Twelve (2.8%) SARS-CoV-2-positive patients required mechanical ventilation, and 2 patients required extracorporeal membrane oxygenation. Two patients died.
In this large cohort of pediatric patients tested for SARS-CoV-2, the rate of infection was low but varied by testing indication. The majority of cases were mild and few children had critical illness.
了解儿童中 2019 年冠状病毒病（COVID-19）的流行情况和临床表现有助于医疗保健提供者和系统为这一新兴大流行做好准备并做出响应。
这是一项对儿科医疗网络中检测到的严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）的患者进行的回顾性病例系列研究，包括检测结果为阳性的患者的临床特征和结局。
在 7256 名接受 SARS-CoV-2 检测的儿童中，有 424 名（5.8%）检测结果为阳性。年龄在 18-21 岁的患者阳性率最高（11.2%），而年龄在 1-5 岁的患者阳性率最低（3.9%）。按种族划分，黑人儿童中阳性率为 10.6%（226/2132），而白人儿童中阳性率为 3.3%（117/3592）。按检测指征划分，有报告暴露或临床症状的患者中阳性率为 21.1%（371/1756），而进行术前或入院前检测的患者中阳性率为 3.8%（53/1410）。在 424 名 SARS-CoV-2 检测结果为阳性的患者中，182 名（42.9%）无合并症，87 名（20.5%）患有哮喘，55 名（13.0%）肥胖。总体而言，52.1%有咳嗽，51.2%有发热，14.6%有呼吸急促。77 名（18.2%）SARS-CoV-2 阳性患者住院，其中 24 名（31.2%）需要呼吸支持。9 名患者接受了 SARS-CoV-2 靶向抗病毒治疗，18 名患者接受了免疫调节治疗。12 名（2.8%）SARS-CoV-2 阳性患者需要机械通气，2 名患者需要体外膜氧合。2 名患者死亡。
在这项对大量接受 SARS-CoV-2 检测的儿科患者进行的研究中，感染率虽低，但因检测指征而异。大多数病例为轻症，很少有儿童患有重症疾病。
