Office of Infection Control and Epidemiology, Children's National Hospital, Washington, DC.
Department of Pediatrics, George Washington University School of Health Science, Washington, DC.
JAMA Netw Open. 2020 Sep 1;3(9):e2020495. doi: 10.1001/jamanetworkopen.2020.20495.
Compared with seasonal influenza, the clinical features and epidemiologic characteristics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus 2019 (COVID-19) in US children remain largely unknown.
To describe the similarities and differences in clinical features between COVID-19 and seasonal influenza in US children.
DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study included children who were diagnosed with laboratory-confirmed COVID-19 between March 25 and May 15, 2020, and children diagnosed with seasonal influenza between October 1, 2019, and June 6, 2020, at Children's National Hospital in the District of Columbia.
COVID-19 or influenza A or B.
Rates of hospitalization, admission to the intensive care unit, and mechanical ventilator use and the association between underlying medical conditions, clinical symptoms, and COVID-19 vs seasonal influenza.
The study included 315 patients diagnosed with COVID-19 (164 [52%] male; median age, 8.3 years [range, 0.03-35.6 years]) and 1402 patients diagnosed with seasonal influenza (743 [53%] male; median age, 3.9 years [range, 0.04-40.4 years]). Patients with COVID-19 and those with seasonal influenza had a similar hospitalization rate (54 [17%] vs 291 [21%], P = .15), intensive care unit admission rate (18 [6%] vs 98 [7%], P = .42), and use of mechanical ventilators (10 [3%] vs 27 [2%], P = .17). More patients hospitalized with COVID-19 than with seasonal influenza reported fever (41 [76%] vs 159 [55%], P = .005), diarrhea or vomiting (14 [26%] vs 36 [12%], P = .01), headache (6 [11%] vs 9 [3%], P = .01), body ache or myalgia (12 [22%] vs 20 [7%], P = .001), and chest pain (6 [11%] vs 9 [3%], P = .01). Differences between patients hospitalized with COVID-19 vs influenza who reported cough (24 [48%] vs 90 [31%], P = .05) and shortness of breath (16 [30%] vs 59 [20%], P = .13) were not statistically significant.
In this cohort study of US children with COVID-19 or seasonal influenza, there was no difference in hospitalization rates, intensive care unit admission rates, and mechanical ventilator use between the 2 groups. More patients hospitalized with COVID-19 than with seasonal influenza reported clinical symptoms at the time of diagnosis.
与季节性流感相比，美国儿童中严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）和 2019 年冠状病毒（COVID-19）的临床特征和流行病学特征在很大程度上仍不清楚。
描述 COVID-19 和季节性流感在美国家庭儿童中的临床特征的异同。
设计、设置和参与者：本回顾性队列研究包括 2020 年 3 月 25 日至 5 月 15 日期间被诊断为实验室确诊的 COVID-19 的儿童，以及 2019 年 10 月 1 日至 2020 年 6 月 6 日期间被诊断为季节性流感的儿童，均来自哥伦比亚特区的儿童国家医院。
COVID-19 或流感 A 或 B。
住院率、入住重症监护病房率和使用机械呼吸机率，以及基础医疗状况、临床症状与 COVID-19 与季节性流感之间的关联。
该研究纳入了 315 例 COVID-19 确诊患儿（164 例[52%]为男性；中位年龄为 8.3 岁[范围：0.03-35.6 岁]）和 1402 例季节性流感确诊患儿（743 例[53%]为男性；中位年龄为 3.9 岁[范围：0.04-40.4 岁]）。COVID-19 患儿与季节性流感患儿的住院率相似（54[17%] vs 291[21%]，P=0.15），重症监护病房入院率相似（18[6%] vs 98[7%]，P=0.42），以及使用机械呼吸机率相似（10[3%] vs 27[2%]，P=0.17）。与季节性流感相比，COVID-19 住院患儿更常报告发热（41[76%] vs 159[55%]，P=0.005）、腹泻或呕吐（14[26%] vs 36[12%]，P=0.01）、头痛（6[11%] vs 9[3%]，P=0.01）、全身疼痛或肌痛（12[22%] vs 20[7%]，P=0.001）和胸痛（6[11%] vs 9[3%]，P=0.01）。COVID-19 患儿与流感患儿中报告咳嗽（24[48%] vs 90[31%]，P=0.05）和呼吸急促（16[30%] vs 59[20%]，P=0.13）的比例无统计学差异。
在这项针对美国 COVID-19 或季节性流感患儿的队列研究中，两组患儿的住院率、重症监护病房入院率和机械通气使用率无差异。与季节性流感相比，更多 COVID-19 住院患儿在诊断时报告有临床症状。
