中国儿童新型冠状病毒肺炎患者的流行病学特征及临床表现：一项多中心回顾性研究
Epidemiological characteristics and clinical manifestations of pediatric patients with COVID-19 in China: A multicenter retrospective study.
作者信息
Bai Yan, Gao Liwei, Wang Xianfeng, Zhong Lili, Li Jingfeng, Ding Shenggang, Zheng Yuejie, Liu Jun, Cui Yuxia, Wang Lina, Han Mingfeng, Liu Jun, Jiang Xinping, Jiang Min, Li Junhua, Chen Ning, Shang Yunxiao, Zhou Hourong, Xu Yi, Lu Gen, Chen Xing, Xu Jizhi, Fan Qihong, Tang Yu, Wu Jiang, Li Cen, Yang Xiaoxiang, Chen Chunxi, Yang Yonghong, Wing-Kin Wong Gary, Shen Adong, Wang Tianyou, Jin Runming, Xu Baoping, Shen Kunling
机构信息
Pediatric Department Union Hospital Tongji Medical College Huazhong University of Science and Technology Hubei China.
China National Clinical Research Center for Respiratory Diseases Department of Respiratory Medicine Beijing Children's Hospital Capital Medical University National Center for Children's Health Beijing China.
出版信息
Pediatr Investig. 2021 Aug 12;5(3):203-210. doi: 10.1002/ped4.12282. eCollection 2021 Sep.
IMPORTANCE
The Coronavirus disease 2019 (COVID-19) global pandemic poses a considerable challenge for pediatricians.
OBJECTIVE
This study aimed to identify the epidemiological characteristics and clinical features of pediatric patients with COVID-19 in China.
METHODS
This multicenter retrospective study included pediatric patients from 46 hospitals in China, covering 12 provinces and two municipalities. Epidemiological, demographic, clinical, laboratory, treatment, and outcome data were analyzed.
RESULTS
In total, 211 pediatric patients with COVID-19 were included in this study. The median age was 7.0 years (range: 22 days to 18 years). Approximately 16.3% of the patients exhibited asymptomatic infections, 23.0% had upper respiratory tract infections, and 60.7% had pneumonia, including two with severe pneumonia and one with critical illness. Approximately 78.7% of the pediatric patients occurred in familial clusters. The most three common symptoms or signs at onset in children with COVID-19 were fever (54.5%), cough (49.3%), and pharyngeal congestion (20.8%). Only 17.6% of the patients presented with decreased lymphocyte count, whereas 13.6% had increased lymphocyte count. Among the patients with pneumonia who exhibited abnormal chest computed tomography findings, 18.2% (23/127) of the patients had no other symptoms. Generally, the chest radiographs showed abnormalities that affected both lungs (49.6%); ground-glass opacity (47.2%) was the most common manifestation. The cure and improvement rates were 86.7% (183/211) and 13.3% (28/211), respectively. Only one patient with an underlying condition received invasive mechanical ventilation; none of the patients died.
INTERPRETATION
Similar to adults, children of all age groups are susceptible to COVID-19. Fortunately, most pediatric patients have mild symptoms or remain asymptomatic, despite the high incidence of pneumonia. Decreased proportions of white blood cells and lymphocytes are less frequent in children than in adults.
重要性
2019年冠状病毒病（COVID-19）全球大流行给儿科医生带来了巨大挑战。
目的
本研究旨在确定中国COVID-19儿科患者的流行病学特征和临床特征。
方法
这项多中心回顾性研究纳入了来自中国46家医院的儿科患者，覆盖12个省和两个直辖市。对流行病学、人口统计学、临床、实验室、治疗及转归数据进行了分析。
结果
本研究共纳入211例COVID-19儿科患者。中位年龄为7.0岁（范围：22天至18岁）。约16.3%的患者表现为无症状感染，23.0%有上呼吸道感染，60.7%有肺炎，其中2例为重症肺炎，1例为危重症。约78.7%的儿科患者呈家庭聚集性发病。COVID-19患儿发病时最常见的三种症状或体征为发热（54.5%）、咳嗽（49.3%）和咽部充血（2..8%）。仅17.6%的患者淋巴细胞计数减少，而13.6%的患者淋巴细胞计数增加。在胸部计算机断层扫描结果异常的肺炎患者中，18.2%（23/127）的患者无其他症状。一般来说，胸部X线片显示双肺均有异常（49.6%）；磨玻璃影（47.2%）是最常见的表现。治愈率和好转率分别为86.7%（183/211）和13.3%（28/211）。仅1例有基础疾病的患者接受了有创机械通气；无患者死亡。
解读
与成人一样，所有年龄段的儿童都易感染COVID-19。幸运的是，尽管肺炎发病率较高，但大多数儿科患者症状较轻或无症状。儿童白细胞和淋巴细胞比例降低的情况比成人少见。
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