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巴黎郊区感染新冠病毒的住院儿童的流行病学及临床表现

Epidemiology and Clinical Presentation of Children Hospitalized with SARS-CoV-2 Infection in Suburbs of Paris.

作者信息

Gaborieau Louise, Delestrain Celine, Bensaid Philippe, Vizeneux Audrey, Blanc Philippe, Garraffo Aurélie, Georget Emilie, Chalvon Arnaud, Garrec Nathalie, Laoudi Yacine, Varon Emmanuelle, Rouget Sébastien, Pupin Alexandre, Abdel Aal Khaled, Toulorge David, Ducrocq Sarah, Barrey Catherine, Pantalone Letitia, Robert Blandine, Joly-Sanchez Lydie, Thach Caroline, Masserot-Lureau Caroline, Chahine Jamilé, Garcia-Roudaut Veronica Risso, Rozental Jonathan, Nathanson Sylvie, Khaled Mohamed, Mandelcwajg Alexis, Demayer Nadia, Muller Stéphanie, Mazerghane Mustapha, Epaud Ralph, Pellegrino Béatrice, Madhi Fouad

机构信息

Service de Pédiatrie Générale, Centre Hospitalier Intercommunal de Créteil, 94000 Créteil, France.

UPMC, Sorbonne Université, 75006 Paris, France.

出版信息

J Clin Med. 2020 Jul 14;9(7):2227. doi: 10.3390/jcm9072227.

Abstract

Understanding the clinical presentation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and prognosis in children is a major issue. Children often present mild symptoms, and some severe forms require paediatric intensive care, with in some cases a fatal prognosis. Our aim was to identify the epidemiological characteristics, clinical presentation, and prognosis of children with coronavirus disease 2019 (Covid-19) hospitalized in Paris suburb hospitals. In this prospective, observational, multicentre study, we included children hospitalized in paediatric departments of Paris suburb hospitals from 23 March 2020 to 10 May 2020, during the national lockdown in France with confirmed SARS-CoV-2 infection (positive RNA test on a nasopharyngeal swab) or highly suspected infection (clinical, biological, and/or radiological data features suggestive for SARS-CoV-2 infection). A total of 192 children were included for confirmed ( = 157) or highly suspected ( = 35) SARS-CoV-2 infection. The median age was one year old (interquartile range 0.125-11) with a sex ratio 1.3:1. Fever was recorded in 147 (76.6%) children and considered poorly tolerated in 29 (15.1%). The symptoms ranged from rhinorrhoea (34.4%) and gastrointestinal (35.5%) to respiratory distress (25%). Only 10 (5.2%) children had anosmia and five (2.6%) had chest pain. An underlying condition was identified in almost 30% of the children in our study. Overall, 24 (12.5%) children were admitted to paediatric intensive care units, 12 required mechanical ventilation, and three died. For children in Paris suburbs, most cases of Covid-19 showed mild or moderate clinical expression. However, one-eighth of children were admitted to paediatric intensive care units and three died.

摘要

了解新型严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染在儿童中的临床表现及预后是一个重要问题。儿童通常症状较轻,部分严重病例需要儿科重症监护,某些情况下预后不良。我们的目的是确定在巴黎郊区医院住院的2019冠状病毒病(Covid-19)患儿的流行病学特征、临床表现及预后。在这项前瞻性、观察性、多中心研究中,我们纳入了2020年3月23日至2020年5月10日法国全国封锁期间在巴黎郊区医院儿科住院的儿童,这些儿童经确诊为SARS-CoV-2感染(鼻咽拭子RNA检测呈阳性)或高度疑似感染(临床、生物学和/或放射学数据特征提示为SARS-CoV-2感染)。共有192名确诊(n = 157)或高度疑似(n = 35)SARS-CoV-2感染的儿童被纳入研究。中位年龄为1岁(四分位间距0.125 - 11岁),男女比例为1.3:1。147名(76.6%)儿童出现发热,其中29名(15.1%)发热耐受性差。症状包括流涕(34.4%)、胃肠道症状(35.5%)和呼吸窘迫(25%)。仅有10名(5.2%)儿童嗅觉丧失,5名(2.6%)儿童胸痛。在我们的研究中,近30%的儿童存在基础疾病。总体而言,24名(12.5%)儿童被收入儿科重症监护病房,12名需要机械通气,3名死亡。对于巴黎郊区的儿童,大多数Covid-19病例临床表现为轻度或中度。然而,八分之一的儿童被收入儿科重症监护病房,3名儿童死亡。

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