无症状和有症状 SARS-CoV-2 感染患儿的临床和流行病学特征比较。

Comparison of Clinical and Epidemiological Characteristics of Asymptomatic and Symptomatic SARS-CoV-2 Infection in Children.

机构信息

Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, 201102, China.

Department of Pediatrics, Shanghai Public Health Clinical Center of Fudan University, Shanghai, 201102, China.

出版信息

Virol Sin. 2020 Dec;35(6):803-810. doi: 10.1007/s12250-020-00312-4. Epub 2020 Nov 4.

Abstract

To understand the epidemiological and clinical features of the symptomatic and asymptomatic pediatric cases of COVID-19, we carried out a prospective study in Shanghai during the period of January 19 to April 30, 2020. A total of 49 children (mean age 11.5 ± 5.12 years) confirmed with SARS-CoV-2 infection were enrolled in the study, including 11 (22.4%) domestic cases and 38 (77.6%) imported cases. Nine (81.8%) local cases and 12 (31.6%) imported cases had a definitive epidemiological exposure. Twenty-eight (57.1%) were symptomatic and 21 (42.9%) were asymptomatic. Neither asymptomatic nor symptomatic cases progressed to severe diseases. The mean duration of viral shedding for SARS-CoV-2 in upper respiratory tract was 14.1 ± 6.4 days in asymptomatic cases and 14.8 ± 8.4 days in symptomatic cases (P > 0.05). Forty-five (91.8%) cases had viral RNA detected in stool. The mean duration of viral shedding in stool was 28.1 ± 13.3 days in asymptomatic cases and 30.8 ± 18.6 days in symptomatic participants (P > 0.05). Children < 7 years shed viral RNA in stool for a longer duration than school-aged children (P < 0.05). Forty-three (87.8%) cases had seropositivity for antibodies against SARS-CoV-2 within 1-3 weeks after confirmation with infection. In conclusion, asymptomatic SARS-CoV-2 infection may be common in children in the community during the COVID-19 pandemic wave. Asymptomatic cases shed viral RNA in a similar pattern as symptomatic cases do. It is of particular concern that asymptomatic individuals are potentially seed transmission of SARS-CoV-2 and pose a challenge to disease control.

摘要

为了了解 COVID-19 有症状和无症状儿科病例的流行病学和临床特征,我们在 2020 年 1 月 19 日至 4 月 30 日期间在上海进行了一项前瞻性研究。共有 49 名确诊 SARS-CoV-2 感染的儿童(平均年龄 11.5±5.12 岁)入组研究,包括 11 例(22.4%)本地病例和 38 例(77.6%)输入性病例。9 例(81.8%)本地病例和 12 例(31.6%)输入性病例有明确的流行病学接触史。28 例(57.1%)为有症状,21 例(42.9%)为无症状。无症状和有症状的病例均未进展为重症。无症状病例和有症状病例的 SARS-CoV-2 在上呼吸道的病毒脱落中位持续时间分别为 14.1±6.4 天和 14.8±8.4 天(P>0.05)。45 例(91.8%)粪便中检测到病毒 RNA。无症状病例的粪便病毒脱落中位持续时间为 28.1±13.3 天,有症状患者为 30.8±18.6 天(P>0.05)。<7 岁的儿童粪便中病毒 RNA 的脱落持续时间长于学龄儿童(P<0.05)。43 例(87.8%)在感染确诊后 1-3 周内 SARS-CoV-2 抗体检测呈阳性。总之,在 COVID-19 流行期间,无症状 SARS-CoV-2 感染可能在社区儿童中很常见。无症状病例的病毒 RNA 脱落模式与有症状病例相似。无症状个体可能是 SARS-CoV-2 的潜在种子传播者,这对疾病控制构成了挑战,这一点尤其令人担忧。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e659/7820061/f57570fd8632/12250_2020_312_Fig1_HTML.jpg

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