Department of Integrated Chinese and Western Medicine, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Pediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China.
J Pediatr. 2020 Sep;224:30-36. doi: 10.1016/j.jpeds.2020.06.041. Epub 2020 Jun 18.
To compare the clinical and laboratory features of severe acute respiratory syndrome 2003 (SARS) and coronavirus disease 2019 (COVID-19) in 2 Chinese pediatric cohorts, given that the causative pathogens and are biologically similar.
This is a cross-sectional study reviewing pediatric patients with SARS (n = 43) and COVID-19 (n = 244) who were admitted to the Princess Margaret Hospital in Hong Kong and Wuhan Children's Hospital in Wuhan, respectively. Demographics, hospital length of stay, and clinical and laboratory features were compared.
Overall, 97.7% of patients with SARS and 85.2% of patients with COVID-19 had epidemiologic associations with known cases. Significantly more patients with SARS developed fever, chills, myalgia, malaise, coryza, sore throat, sputum production, nausea, headache, and dizziness than patients with COVID-19. No patients with SARS were asymptomatic at the time of admission, whereas 29.1% and 20.9% of patients with COVID-19 were asymptomatic on admission and throughout their hospital stay, respectively. More patients with SARS required oxygen supplementation than patients with COVID-19 (18.6 vs 4.7%; P = .004). Only 1.6% of patients with COVID-19 and 2.3% of patients with SARS required mechanical ventilation. Leukopenia (37.2% vs 18.6%; P = .008), lymphopenia (95.4% vs 32.6%; P < .01), and thrombocytopenia (41.9% vs 3.8%; P < .001) were significantly more common in patients with SARS than in patients with COVID-19. The duration between positive and negative nasopharyngeal aspirate and the length in hospital stay were similar in patients with COVID-19, regardless of whether they were asymptomatic or symptomatic, suggesting a similar duration of viral shedding.
Children with COVID-19 were less symptomatic and had more favorable hematologic findings than children with SARS.
由于导致 SARS-CoV-2003（SARS）和 2019 年冠状病毒病（COVID-19）的病原体在生物学上相似，本研究比较了 2 个中国儿科队列中严重急性呼吸综合征 2003（SARS）和 2019 年冠状病毒病（COVID-19）的临床和实验室特征。
这是一项回顾性研究，纳入了分别在香港玛嘉烈医院和武汉儿童医院住院的 SARS（n=43）和 COVID-19（n=244）患儿。比较了人口统计学、住院时间和临床及实验室特征。
总体而言，97.7%的 SARS 患儿和 85.2%的 COVID-19 患儿与已知病例有流行病学关联。SARS 患儿发热、寒战、肌痛、不适、鼻塞、咽痛、咳痰、恶心、头痛和头晕的发生率明显高于 COVID-19 患儿。SARS 患儿入院时均无无症状，而 COVID-19 患儿入院时有 29.1%无症状，住院期间有 20.9%无症状。需要氧疗的 SARS 患儿多于 COVID-19 患儿（18.6%比 4.7%；P=0.004）。仅 1.6%的 COVID-19 患儿和 2.3%的 SARS 患儿需要机械通气。SARS 患儿白细胞减少症（37.2%比 18.6%；P=0.008）、淋巴细胞减少症（95.4%比 32.6%；P<0.01）和血小板减少症（41.9%比 3.8%；P<0.001）更为常见。COVID-19 患儿无论有无症状，鼻咽抽吸物转阴时间和住院时间均相似，提示病毒脱落时间相似。
COVID-19 患儿的症状比 SARS 患儿轻，血液学表现更有利。
