Department of Respiratory Medicine, Wuhan Children' Hospital.
Department of Gastroenterology, Zhongnan Hospital of Wuhan University.
Medicine (Baltimore). 2021 Mar 19;100(11):e24315. doi: 10.1097/MD.0000000000024315.
Since the outbreak of coronavirus disease 2019 (COVID-19) in Wuhan, considerable attention has been paid on its epidemiology and clinical characteristics in children patients. However, it is also crucial for clinicians to summarize and investigate the co-infection of SARS-CoV-2 in children.We retrospectively reviewed the clinical manifestations, laboratory findings, and imaging characteristics of COVID-19 patients in co-infection group (CI, n = 27) and single infection group (SI, n = 54). Samples were tested for multiple pathogens.A high incidence (27/81, 33%) of co-infection in children with COVID-19 was revealed. The most frequent co-infected pathogen was mycoplasma pneumoniae (MP, 20/81, 25%), followed by virus (6/81, 7%), and bacteria (4/81, 5%). No significant difference in clinical characteristics, laboratory examinations, or hospital stay was observed between the patients with co-infections and those with monomicrobial, only lower in white blood cell counts (CI: 5.54 ± 0.36 vs SI: 7.38 ± 0.37, P = .002), neutrophil counts (CI: 2.20 ± 0.20 vs SI: 2.92 ± 0.23, P = .024) and lymphocyte counts (CI: 2.72 ± 0.024 vs SI: 3.87 ± 0.28, P = .006). Compared with the patients with monomicrobial, chest imaging of those with co-infections showed consolidation in more cases (CI: 29.6% vs SI: 11.1%, P = .038) and duration of positive in nucleic acid was shorter (CI: 6.69 ± 0.82 vs SI: 9.69 ± 0.74, P = .015).Co-infection was relatively common in children with COVID-19, almost 1/3 had co-infection, most commonly caused by MP. Co-infection did not cause a significant exacerbation in clinical manifestations.
自 2019 年冠状病毒病(COVID-19)在武汉爆发以来,人们对儿童患者的流行病学和临床特征给予了相当大的关注。然而,对于临床医生来说,总结和调查 SARS-CoV-2 在儿童中的合并感染也很重要。我们回顾性分析了合并感染组(CI,n=27)和单一感染组(SI,n=54)COVID-19 患者的临床表现、实验室检查和影像学特征。对多种病原体进行了检测。
结果显示,儿童 COVID-19 合并感染的发生率较高(27/81,33%)。最常见的合并感染病原体是肺炎支原体(MP,20/81,25%),其次是病毒(6/81,7%)和细菌(4/81,5%)。合并感染患者与单一感染患者的临床特征、实验室检查或住院时间无显著差异,仅白细胞计数较低(CI:5.54±0.36 vs SI:7.38±0.37,P=0.002)、中性粒细胞计数(CI:2.20±0.20 vs SI:2.92±0.23,P=0.024)和淋巴细胞计数(CI:2.72±0.024 vs SI:3.87±0.28,P=0.006)。与单一感染患者相比,合并感染患者的胸部影像学显示更多的实变(CI:29.6% vs SI:11.1%,P=0.038),核酸阳性持续时间更短(CI:6.69±0.82 vs SI:9.69±0.74,P=0.015)。
儿童 COVID-19 合并感染较为常见,近 1/3 合并感染,最常见的病原体是 MP。合并感染并未导致临床表现明显加重。