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土耳其一家流行医院 81 例 COVID-19 患儿的流行病学和临床特征:一项观察性队列研究。

The Epidemiological and Clinical Characteristics of 81 Children with COVID-19 in a Pandemic Hospital in Turkey: an Observational Cohort Study.

机构信息

Department of Pediatrics, Bursa City Hospital, Bursa, Turkey.

Department of Pediatric Emergency, Bursa City Hospital, Bursa, Turkey.

出版信息

J Korean Med Sci. 2020 Jun 29;35(25):e236. doi: 10.3346/jkms.2020.35.e236.

Abstract

BACKGROUND

Coronavirus disease-2019 (COVID-19) pandemic has affected millions of people throughout the world since December 2019. However, there is a limited amount of data about pediatric patients infected with the disease agent, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

METHODS

The epidemiological, laboratory, radiological, and treatment features of the pediatric patients who were positive for SARS-CoV-2 based on the reverse-transcription polymerase chain reaction (RT-PCR) test, were investigated retrospectively.

RESULTS

The median age of 81 children included in the study was 9.50 years (0-17.75 years). The most frequent symptoms at the time of admission were fever (58%), cough (52%), and fatigue or myalgia (19%). The abnormal laboratory findings in these cases were decreased lymphocytes (2.5%, n = 2), leucopenia (5%, n = 4), and increased lactate dehydrogenase (17.2%, n = 14), C-reactive protein (16%, n = 13), procalcitonin (3.7%, n = 3), and D-dimer (12.3%, n = 10). Three (4%) patients had consolidation in chest computed tomography, and three (4%) had ground-glass opacities. None of the patients needed intensive care except for the newborns. The median time to turn SARS-CoV-2 negative in the RT-PCR test was 5 (3-10) days. The median length of hospital stay was 5 (4-10) days. The time to turn SARS-CoV-2 negative in the RT-PCR test and the length of hospital stay were significantly longer for those aged five years or younger than others ( = 0.037, = 0.01).

CONCLUSION

Compared to adults, COVID-19 is milder and more distinctive in children. As a result, more conservative approaches might be preferred in children for the diagnostic, clinical, and even therapeutic applications.

摘要

背景

自 2019 年 12 月以来,冠状病毒病 2019(COVID-19)大流行已影响到全世界数百万人。然而,关于感染疾病因子——严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)的儿科患者的数据有限。

方法

回顾性调查了基于逆转录聚合酶链反应(RT-PCR)检测呈 SARS-CoV-2 阳性的儿科患者的流行病学、实验室、影像学和治疗特征。

结果

研究纳入的 81 名儿童的中位年龄为 9.50 岁(0-17.75 岁)。入院时最常见的症状是发热(58%)、咳嗽(52%)和乏力或肌痛(19%)。这些病例的异常实验室发现包括淋巴细胞减少(2.5%,n=2)、白细胞减少(5%,n=4)、乳酸脱氢酶升高(17.2%,n=14)、C 反应蛋白升高(16%,n=13)、降钙素原升高(3.7%,n=3)和 D-二聚体升高(12.3%,n=10)。3(4%)例患儿胸部 CT 有实变,3(4%)例有磨玻璃影。除新生儿外,无患儿需要重症监护。RT-PCR 检测中 SARS-CoV-2 转阴的中位时间为 5(3-10)天。中位住院时间为 5(4-10)天。年龄在 5 岁及以下者 RT-PCR 检测中 SARS-CoV-2 转阴时间和住院时间均明显长于其他患者( = 0.037, = 0.01)。

结论

与成人相比,COVID-19 在儿童中更轻微且更具特征性。因此,在诊断、临床甚至治疗应用中,儿童可能更倾向于采用更保守的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78f1/7324269/c06f80b36b3b/jkms-35-e236-g001.jpg

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