Liu Qian, Zhang Yong, Long Yuan
Departments of cardiovascular, Wuhan Children's Hospital(Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Hubei, China.
Medicine (Baltimore). 2020 Aug 14;99(33):e21427. doi: 10.1097/MD.0000000000021427.
Coronavirus disease 2019 (COVID-19), now a global pandemic, has spread to a large number of countries around the world. Symptoms of COVID-19 can range from mild to severe, including fever, cough, shortness of breath, and pneumonia. Some cases even remain asymptomatic. Data regarding the epidemiological and clinical features of children with COVID-19 are limited. Symptoms in children are thought to be atypical when compared with adults. As a result, diagnosis in many children is likely to be missed. Children presenting with atypical symptoms, especially those with a history of exposure, should be referred to early screening.
A 23-month-old boy presented with a 2-day history of diarrhea. Chest computed tomography scan showed pneumonia. After admission to the hospital, the patient exhibited no diarrhea or other symptoms. Positive presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, was confirmed by 5 consecutive rounds of nucleic acid amplification testing of nasopharyngeal swabs. The patient was also found to have liver damage.
Swabs were obtained for detection of SARS-CoV-2 RNA by established methods.
Chinese traditional medicine prescription OUTCOMES:: Following treatment, signs of pneumonia on computed tomography scans were observed to be partially absorbed, and 2 consecutive rounds of nucleic acid amplification testing of swab samples were negative. The patient was discharged on the 21st day after admission to the hospital. On the 21st day after discharge, the patient had no recurrence of disease, no recurrence of pulmonary lesions, and normal liver function.
This case study suggests that diarrhea not explained by common causes, such as acute gastroenteritis, could be a preliminary symptom of SARS-CoV-2 infection in children. Despite the lack of the presence of a fever or cough, lung pulmonary lesions were present in this child. SARS-CoV-2 infection may also cause hepatic injury. Even during the SARS-CoV-2 pneumonia recovery period, IgM and IgG antibodies can be positive for a long time.
2019年冠状病毒病(COVID-19)现已成为全球大流行疾病,已蔓延至世界上许多国家。COVID-19的症状从轻微到严重不等,包括发热、咳嗽、呼吸急促和肺炎。有些病例甚至没有症状。关于COVID-19儿童的流行病学和临床特征的数据有限。与成人相比,儿童的症状被认为是非典型的。因此,许多儿童可能会漏诊。出现非典型症状的儿童,尤其是有接触史的儿童,应尽早进行筛查。
一名23个月大的男孩有2天腹泻病史。胸部计算机断层扫描显示有肺炎。入院后,该患者未出现腹泻或其他症状。通过对鼻咽拭子进行连续5轮核酸扩增检测,确诊为严重急性呼吸综合征冠状病毒2(SARS-CoV-2)阳性,该病毒可导致COVID-19。还发现该患者有肝损伤。
采用既定方法采集拭子检测SARS-CoV-2 RNA。
中药方剂
治疗后,计算机断层扫描显示的肺炎迹象部分吸收,拭子样本连续2轮核酸扩增检测呈阴性。患者在入院后第21天出院。出院后第21天,患者未复发疾病,肺部病变未复发,肝功能正常。
本病例研究表明,由常见原因如急性胃肠炎无法解释的腹泻可能是儿童SARS-CoV-2感染的初步症状。尽管该患儿没有发热或咳嗽,但存在肺部病变。SARS-CoV-2感染也可能导致肝损伤。即使在SARS-CoV-2肺炎恢复期,IgM和IgG抗体也可能长期呈阳性。