King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, King Abdulaziz Medical City, Riyadh, Saudi Arabia; Department of Pediatrics, King Abdullah Specialist Children's Hospital, Riyadh, Saudi Arabia.
King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, King Abdulaziz Medical City, Riyadh, Saudi Arabia; Department of Pediatrics, King Abdullah Specialist Children's Hospital, Riyadh, Saudi Arabia.
J Infect Public Health. 2021 Apr;14(4):446-453. doi: 10.1016/j.jiph.2020.12.034. Epub 2021 Jan 14.
Coronavirus disease 2019 (COVID-19) pandemic caused by SARS-CoV-2 was first identified in Wuhan, China. All ages are susceptible to SARS-CoV-2 infection. Few studies had reported milder course in children however, severe course of illness has been reported. We aimed to describe the clinical features of COVID-19 in pediatric patients including diagnostic findings and therapeutic interventions in sever disease manifestation.
We retrospectively reviewed 742 patients with SARS-CoV-2 proven infection at King Abdullah Specialist Children's Hospital, from April 2020 and July 2020. Inpatients, outpatient, including those with sever manifestation treated at the Intensive Care Unit (ICU) were included. We collected data including demographic data, comorbidities, symptoms, imaging data, laboratory findings, treatments and clinical outcomes of patients with COVID-19.
Among of 742 patients, 71 (9.6%) were hospitalized. The median age of patients was 75 months old and 53.6 were male. A total of 461 (62.1%) had close contact with confirmed cases, 45 (6.1%) had no contact history, and 236 (31.8%) with unknown exposure risk. The most common symptoms at the onset of illness were fever (32.5%), respiratory symptoms (21%) and gastrointestinal symptoms (10.3%). Among the entire cohort, 7 patients were admitted to PICU with COVID-19 related symptoms, five patients diagnosed with MIS-C, one patient with Kawasaki, and one patient with pneumonia. All patients received supportive therapy, no antiviral treatment had been used however, in MIS-C patients IVIG had been given to all patients, five patients received Anakinra; and one patient received tocilizumab.
In this study, children infected with SARS-CoV-2 are less likely to develop symptomatic or serious diseases. Among symptomatic children, the most common clinical features were fever and respiratory symptoms followed by gastrointestinal manifestations. The majority of infected children have reported contact with an infected individual. MIS-C associated with COVID-19 is a severe presentation of SARS-CoV-2 infection and of a major concern as an overlapping features with other diseases could happen, making the diagnosis challenging.
由 SARS-CoV-2 引起的 2019 年冠状病毒病（COVID-19）大流行最初在中国武汉被发现。所有年龄段的人都容易感染 SARS-CoV-2。然而，已有少数研究报告称儿童的病程较轻，但也有严重的疾病报告。我们旨在描述 COVID-19 儿科患者的临床特征，包括在严重疾病表现中诊断发现和治疗干预。
我们回顾性分析了 2020 年 4 月至 7 月在阿卜杜拉国王儿童专科医院（King Abdullah Specialist Children's Hospital）确诊为 SARS-CoV-2 感染的 742 名患者。包括住院、门诊，包括在重症监护病房（Intensive Care Unit，ICU）接受治疗的严重疾病患者。我们收集了患者的人口统计学数据、合并症、症状、影像学数据、实验室发现、治疗和临床结局。
742 名患者中，71 名（9.6%）住院。患者的中位年龄为 75 个月，53.6 名为男性。共有 461 名（62.1%）有与确诊病例的密切接触史，45 名（6.1%）无接触史，236 名（31.8%）接触史未知。发病时最常见的症状是发热（32.5%）、呼吸道症状（21%）和胃肠道症状（10.3%）。在整个队列中，7 名患者因 COVID-19 相关症状入住 PICU，5 名患者诊断为 MIS-C，1 名患者为川崎病，1 名患者为肺炎。所有患者均接受支持性治疗，未使用抗病毒治疗，但在 MIS-C 患者中，所有患者均给予 IVIG，5 名患者给予 Anakinra；1 名患者给予托珠单抗。
在这项研究中，感染 SARS-CoV-2 的儿童不太可能出现有症状或严重疾病。在有症状的儿童中，最常见的临床特征是发热和呼吸道症状，其次是胃肠道表现。大多数感染儿童均有接触过感染个体的报告。与 COVID-19 相关的 MIS-C 是 SARS-CoV-2 感染的严重表现，是一个主要关注点，因为它可能与其他疾病重叠，使诊断具有挑战性。
