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[葡萄牙103例感染新型冠状病毒的儿童病例系列]

[Case Series of 103 Children with SARS-CoV-2 Infection in Portugal].

作者信息

Picão de Carvalho Clara, Castro Carolina, Sampaio Graça Isabel, Lorenzo Cristina, Barbosa Rodrigues Ana, Inácio Rafael, Prata Filipa, Mouzinho Ana, Pinto Sara, Marques José Gonçalo

机构信息

Unidade de Infecciologia e Imunodeficiências. Departamento de Pediatria. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Portugal.

Unidade de Infecciologia e Imunodeficiências. Departamento de Pediatria. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa. Serviço de Cardiologia Pediátrica. Hospital de Santa Cruz. Centro Hospitalar Lisboa Ocidental. Oeiras. Portugal.

出版信息

Acta Med Port. 2020 Dec 2;33(12):795-802. doi: 10.20344/amp.14537. Epub 2020 Sep 14.

Abstract

INTRODUCTION

The North Lisbon University Hospital Center was activated for referral of SARS-CoV-2 infected patients on the 11th March 2020. The aim of this study is to describe the experience at the Department of Pediatrics in the approach and the clinical outcomes of infected children.

MATERIAL AND METHODS

A descriptive observational study was performed. Children and adolescents (0 to 18 years) with SARS-CoV-2 infection, diagnosed in the emergency room or admitted to the Department of Pediatrics between March 11th and June 18th, were included. Hospital records and Trace COVID-19 platform were reviewed and patient caregivers were interviewed to assess follow up.

RESULTS

Among 103 diagnosed children, 83% had a known previous contact with an infected patient, 43% presented fever and 42% presented respiratory symptoms. Ten percent had risk factors and 21% were aged under one year old. Ten percent were hospitalised, one needing intensive care, with paediatric inflammatory multisystem syndrome. Blood tests were performed in 9% and chest radiograph in 7%. No children required ventilation, antiviral therapy or underwent thoracic computed tomography scan. Eight percent of children returned to the emergency room and one child was hospitalised. The clinical outcome is known in 101 patients and is favourable in all.

DISCUSSION

Most children had an epidemiological link and little clinical repercussion, even during the first year of life. The expected mild severity in children justified the use of established clinical criteria and recommendations for similar conditions, regarding tests and hospitalizations. No antiviral treatments were given due to lack of evidence of its benefits.

CONCLUSION

This strategy contributed to a low consumption of hospital resources and proved safe in this series.

摘要

引言

2020年3月11日,北里斯本大学医院中心开始接收新型冠状病毒肺炎(SARS-CoV-2)感染患者的转诊。本研究旨在描述儿科在诊治感染儿童方面的经验及临床结局。

材料与方法

开展一项描述性观察研究。纳入2020年3月11日至6月18日期间在急诊室确诊或入住儿科的新型冠状病毒肺炎感染儿童及青少年(0至18岁)。查阅医院记录和“追踪新冠-19”平台信息,并对患者家属进行访谈以评估随访情况。

结果

在103例确诊儿童中,83%曾与感染患者有过已知接触史,43%出现发热,42%出现呼吸道症状。10%有危险因素,21%年龄在1岁以下。10%住院治疗,其中1例因小儿炎症性多系统综合征需要重症监护。9%的患儿进行了血液检查,7%进行了胸部X光检查。无患儿需要机械通气、抗病毒治疗或接受胸部计算机断层扫描。8%的患儿返回急诊室,1例患儿再次住院。101例患者的临床结局已知,均为良好。

讨论

大多数儿童有流行病学关联,但临床影响较小,即使在1岁以内的儿童中也是如此。儿童预期病情较轻,这证明在检查和住院方面采用既定的临床标准及针对类似情况的建议是合理的。由于缺乏抗病毒治疗有益的证据,未给予抗病毒治疗。

结论

该策略有助于减少医院资源消耗,在本系列研究中证明是安全的。

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