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儿童 COVID-19 的临床和影像学特征。

Clinical and imaging features of pediatric COVID-19.

机构信息

Affiliated Hospital of Hebei University, Baoding, 071000, Hebei Province, China.

Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China.

出版信息

Ital J Pediatr. 2020 Oct 14;46(1):153. doi: 10.1186/s13052-020-00917-1.

Abstract

BACKGROUND

Pediatric COVID-19 is relatively mild and may vary from that in adults. This study was to investigate the epidemic, clinical, and imaging features of pediatric COVID-19 pneumonia for early diagnosis and treatment.

METHODS

Forty-one children infected with COVID-19 were analyzed in the epidemic, clinical and imaging data.

RESULTS

Among 30 children with mild COVID-19, seven had no symptoms, fifteen had low or mediate fever, and eight presented with cough, nasal congestion, diarrhea, headache, or fatigue. Among eleven children with moderate COVID-19, nine presented with low or mediate fever, accompanied with cough and runny nose, and two had no symptoms. Significantly (P < 0.05) more children had a greater rate of cough in moderate than in mild COVID-19. Thirty children with mild COVID-19 were negative in pulmonary CT imaging, whereas eleven children with moderate COVID-19 had pulmonary lesions, including ground glass opacity in ten (90.9%), patches of high density in six (54.5%), consolidation in three (27.3%), and enlarged bronchovascular bundles in seven (63.6%). The lesions were distributed along the bronchus in five patients (45.5%). The lymph nodes were enlarged in the pulmonary hilum in two patients (18.2%). The lesions were presented in the right upper lobe in two patients (18.1%), right middle lobe in one (9.1%), right lower lobe in six (54.5%), left upper lobe in five (45.5%), and left lower lobe in eight (72.7%).

CONCLUSIONS

Children with COVID-19 have mild or moderate clinical and imaging presentations. A better understanding of the clinical and CT imaging helps ascertaining those with negative nucleic acid and reducing misdiagnosis rate for those with atypical and concealed symptoms.

摘要

背景

儿童 COVID-19 相对较轻,可能与成人不同。本研究旨在探讨儿童 COVID-19 肺炎的流行、临床和影像学特征,以便早期诊断和治疗。

方法

分析了 41 例感染 COVID-19 的儿童的流行、临床和影像学数据。

结果

30 例轻度 COVID-19 患儿中,7 例无症状,15 例低热,8 例咳嗽、鼻塞、腹泻、头痛或乏力。11 例中度 COVID-19 患儿中,9 例低热,伴有咳嗽、流涕,2 例无症状。中度 COVID-19 患儿咳嗽发生率明显高于轻度 COVID-19(P<0.05)。30 例轻度 COVID-19 患儿肺部 CT 影像均为阴性,11 例中度 COVID-19 患儿肺部有病变,包括 10 例(90.9%)磨玻璃影、6 例(54.5%)斑片状高密度影、3 例(27.3%)实变影和 7 例(63.6%)支气管血管束增粗。5 例(45.5%)病变沿支气管分布。2 例(18.2%)患儿肺门淋巴结肿大。2 例(18.1%)病变位于右上叶,1 例(9.1%)位于右中叶,6 例(54.5%)位于右下叶,5 例(45.5%)位于左上叶,8 例(72.7%)位于左下叶。

结论

儿童 COVID-19 临床表现较轻或为中度。更好地了解临床和 CT 影像有助于确定核酸阴性的患者,减少不典型和隐匿性症状患者的误诊率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d4f/7558730/6f3ba08b3fea/13052_2020_917_Fig1_HTML.jpg

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