Infectious Disease Service, Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore.
Ann Acad Med Singap. 2020 Aug;49(8):530-537.
In this study, a comparison of clinical, epidemiological and laboratory parameters between symptomatic and asymptomatic children with SARS-CoV-2 infection was performed.
Data from all children with laboratory confirmed SARS-CoV-2 infection admitted to KK Women's and Children's Hospital (KKH), Singapore, from January to May 2020 were analysed.
Of the 39 COVID-19 children included, 38.5% were asymptomatic. Household transmission accounted for 95% of cases. The presenting symptoms of symptomatic children were low-grade fever (54.2%), rhinorrhoea (45.8%), sore throat (25%), diarrhoea (12.5%) and acute olfactory dysfunction (5.4%). Children of Chinese ethnicity (37.5% vs 6.7%), complete blood count (45.8% vs 6.7%) and liver enzyme abnormalities (25% vs 7.7%) were more common in symptomatic versus asymptomatic children. All children had a mild disease course and none required oxygen supplementation or intensive care.
The high proportion of asymptomatic infected children coupled with household transmission as the main source of paediatric COVID-19 infection underscores the importance of early screening and isolation of children upon detection of an index case of COVID-19 in a household. Symptomatic children were more likely to have abnormal laboratory parameters but they did not have a poorer outcome compared to asymptomatic cases.
本研究比较了有症状和无症状 SARS-CoV-2 感染儿童的临床、流行病学和实验室参数。
分析了 2020 年 1 月至 5 月期间所有在新加坡 KK 妇女儿童医院（KKH）确诊 SARS-CoV-2 感染的儿童的数据。
39 名 COVID-19 患儿中，38.5%为无症状。家庭传播占病例的 95%。有症状患儿的表现症状为低热（54.2%）、流涕（45.8%）、咽痛（25%）、腹泻（12.5%）和急性嗅觉功能障碍（5.4%）。中国血统的儿童（37.5%比 6.7%）、全血细胞计数（45.8%比 6.7%）和肝酶异常（25%比 7.7%）在有症状患儿中更为常见。所有患儿的疾病均较轻，均无需吸氧或重症监护。
感染儿童中无症状的比例较高，加上家庭传播是儿童 COVID-19 感染的主要来源，这突出表明，一旦家庭中发现 COVID-19 确诊病例，应尽早对儿童进行筛查和隔离。有症状的患儿更可能出现异常的实验室参数，但与无症状病例相比，其结局并未更差。
