Department of Laboratory Medicine, Huangshi Maternity and Children's Health Hospital, Edong Healthcare Group, No. 80, Guilin South Road, Xialu District, Huangshi City, Hubei Province, China.
Department of Pediatrics, Huangshi Maternity and Children's Health Hospital, Edong Healthcare Group, No. 80, Guilin South Road, Xialu District, Huangshi City, Hubei Province, China.
Biomed J. 2021 Mar;44(1):94-100. doi: 10.1016/j.bj.2020.10.007. Epub 2020 Oct 24.
A pandemic caused by SARS-CoV-2 infection (COVID-19) has rapidly spread across the globe. Although many articles have established the clinical characteristics of adult COVID-19 patients so far, limited data are available for children. The aim of this study was to reveal the clinical features, laboratory findings and nucleic acid test results of ten pediatric cases.
In this retrospective single-center cohort study, pediatric cases with COVID-19 infection were consecutively enrolled in one hospital in Huangshi, China from January 1 to March 11, 2020.
A total of 10 children with COVID-19 were recruited. Of them, four were the asymptomatic type, one was the mild type, and five were the moderate type (including two subclinical ones). All patients were from family clusters. Only fever, nasal discharge and nasal congestion were observed. Lymphopenia and leukopenia were uncommon in our sample but elevated levels of lactate dehydrogenase (LDH) and alpha-hydroxybutyrate dehydrogenase (α-HBDH) were observed frequently. Of these laboratory test variables, no statistical difference was identified between asymptomatic and symptomatic patients. Abnormalities in radiological data were detected in five patients, and representative findings of chest CT images were patchy shadows and ground-glass opacities. There were two cases whose oropharyngeal nucleic acid tests reversed to positive after one negative result, and two patients whose oropharyngeal swabs tested negative but rectal swabs showed positive.
Clinical symptoms were mild in children with COVID-19. Increased levels of LDH and α-HBDH were potential clinical biomarkers for pediatric cases. More attention should be paid to the SARS-CoV-2 viral assessment of rectal swabs before patients are discharged.
由 SARS-CoV-2 感染引起的大流行（COVID-19）已在全球迅速蔓延。尽管迄今为止已有许多文章确定了成人 COVID-19 患者的临床特征，但儿童的数据有限。本研究旨在揭示 10 例儿科病例的临床特征、实验室发现和核酸检测结果。
在这项回顾性单中心队列研究中，我们连续纳入了 2020 年 1 月 1 日至 3 月 11 日期间中国黄石市一家医院收治的 COVID-19 感染的儿科病例。
共纳入 10 例 COVID-19 患儿。其中无症状型 4 例，轻型 1 例，中型 5 例（包括 2 例亚临床型）。所有患者均来自家庭聚集性病例。仅观察到发热、流涕和鼻塞。淋巴细胞减少和白细胞减少在我们的样本中并不常见，但经常观察到乳酸脱氢酶（LDH）和α-羟丁酸脱氢酶（α-HBDH）水平升高。在这些实验室检测变量中，无症状和有症状患者之间没有统计学差异。5 例患者的影像学数据异常，胸部 CT 图像的典型表现为斑片状阴影和磨玻璃影。有 2 例患者的咽拭子核酸检测结果先转为阴性后又转为阳性，2 例患者的咽拭子检测结果阴性但直肠拭子检测结果阳性。
儿童 COVID-19 的临床症状较轻。LDH 和α-HBDH 水平升高可能是儿科病例的潜在临床生物标志物。在患者出院前，应更加关注对直肠拭子的 SARS-CoV-2 病毒评估。
