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西班牙免疫抑制儿童感染 SARS-CoV-2 的临床结局。

Clinical outcome of SARS-CoV-2 infection in immunosuppressed children in Spain.

机构信息

Pediatric Hemato-Oncology Department, Hospital Universitario La Paz, Madrid, Spain.

Pediatric Nephrology Department, Hospital Universitario La Paz, Madrid, Spain.

出版信息

Eur J Pediatr. 2021 Mar;180(3):967-971. doi: 10.1007/s00431-020-03793-3. Epub 2020 Aug 29.

Abstract

Limited information is available regarding SARS-CoV-2 infections in children with underlying diseases. A retrospective study of children less than 15 years old with primary or secondary immunosuppression infected with SARS-CoV-2 during March 2020 was performed. In this series, 8 immunocompromised patients with COVID-19 disease are reported, accounting for 15% of the positive cases detected in children in a reference hospital. The severity of the symptoms was mild-moderate in the majority with a predominance of febrile syndrome, with mild radiological involvement and in some cases with mild respiratory distress that required oxygen therapy. The rational and prudent management of these patients is discussed, evaluating possible treatments and options for hospitalization or outpatient follow-up.Conclusion: In our experience, monitoring of children with immunosuppression and COVID-19 disease can be performed as outpatients if close monitoring is possible. Hospitalization should be assessed when high fever, radiological involvement, and/or respiratory distress are present. What is Known: • SARS-CoV-2 infection is usually mild in children. What is New: • Outcome of immunosuppressed children with COVID-19 is generally good, with a mild-moderate course.

摘要

关于患有基础疾病的儿童中 SARS-CoV-2 感染的信息有限。对 2020 年 3 月期间原发性或继发性免疫抑制的 15 岁以下儿童感染 SARS-CoV-2 的情况进行了回顾性研究。在该系列中,报告了 8 例 COVID-19 疾病的免疫功能低下患者,占参考医院检测到的儿童阳性病例的 15%。大多数患者的症状为轻-中度,以发热综合征为主,影像学受累轻微,某些情况下有轻度呼吸窘迫,需要吸氧治疗。讨论了对这些患者进行合理和谨慎的管理,评估了可能的治疗方法以及住院或门诊随访的选择。结论:根据我们的经验,如果可以密切监测,可对患有免疫抑制和 COVID-19 疾病的儿童进行门诊监测。当出现高热、影像学受累和/或呼吸窘迫时,应评估住院治疗。已知:• SARS-CoV-2 感染在儿童中通常较轻。新发现:• COVID-19 免疫抑制儿童的预后通常较好,病程为轻-中度。

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