Department of Radiology, The Second Hospital of Nanjing Nanjing University of Chinese Medicine, Nanjing, P.R. China.
Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, P.R. China.
Ann Med. 2022 Dec;54(1):2391-2401. doi: 10.1080/07853890.2022.2114608.
To analyse the clinical symptoms, laboratory examinations and chest CT findings of children infected by the B.1.617.2 variant of COVID-19 and to compare the differences between clinical subtypes.
Fifty-three children (28 males, 25 females; age ranging from 4 months to 17 years) were included with B.1.617.2 variant infection in Nanjing, China, from July 21 to August 12 2021. Clinical data from patients were collected and analysed in groups of mild and common types. Imaging data were divided into three stages for evaluation: early, intermediate and late stages.
In our study, fever (53%), cough (34%) and pharyngeal discomfort (28%) were the main symptoms. There were no differences in clinical symptoms between the mild and common type. The most common laboratory test items outside the normal range were decreased mean corpuscular volume (68%), lymphocyte percentage (64% elevated and 2% decreased) and decreased serum alkaline phosphatase concentration (66%). The differences in haemoglobin and monocyte percentages between the mild and common types were statistically significant ( = .037 and .033, respectively). No influencing factor was statistically significant in the regression analysis of both symptoms and clinical subtypes. The main CT findings were ground-glass opacity and consolidation located in the periphery and bilateral multilobed involvement. The mean CT score was 1.6. CT score correlated with packet cell volume, haemoglobin, mean erythrocyte volume, mean platelet volume and platelet distribution width.
The pathogenetic condition of children with B.1.617.2 variant infection is mild. Although there were intergroup differences in some blood cell analyses, T-lymphocyte counts, and comprehensive biochemical indicators, no factors had a significant effect on clinical typing and the presence or absence of symptoms. CT findings and CT scores reflect disease stage and pathological changes and correlate moderately with laboratory tests, making them of good value for disease diagnosis and monitoring.Key MessagesPaediatric patients infected with B.1.617.2 variant have a milder clinical and imaging presentation than adults and are similar to the prototype infection.CT findings and scores which reflect disease stages and pathological changes.There is a correlation between chest CT and laboratory tests, which can be useful for the diagnosis and follow-up of the disease.
分析儿童感染 COVID-19 的 B.1.617.2 变异株的临床症状、实验室检查和胸部 CT 表现,并比较临床亚型之间的差异。
2021 年 7 月 21 日至 8 月 12 日,在中国南京,纳入了 53 例 B.1.617.2 变异株感染的儿童(男 28 例,女 25 例;年龄 4 个月至 17 岁)。对患者的临床资料进行分组分析,分为轻症和普通型。将影像学资料分为早期、中期和晚期三个阶段进行评估。
在本研究中,发热(53%)、咳嗽(34%)和咽部不适(28%)是主要症状。轻症和普通型之间的临床症状无差异。最常见的实验室检查异常项目为平均红细胞体积降低(68%)、淋巴细胞百分比升高(64%,2%降低)和血清碱性磷酸酶浓度降低(66%)。轻症和普通型之间的血红蛋白和单核细胞百分比差异有统计学意义(=.037 和.033)。在症状和临床亚型的回归分析中,没有统计学意义的影响因素。主要 CT 表现为位于外周和双侧多叶的磨玻璃影和实变。平均 CT 评分 1.6。CT 评分与网织红细胞体积、血红蛋白、平均红细胞体积、平均血小板体积和血小板分布宽度相关。
儿童感染 B.1.617.2 变异株的发病情况较轻。虽然在一些血细胞分析、T 淋巴细胞计数和综合生化指标方面存在组间差异,但没有因素对临床分型和症状的出现有显著影响。CT 表现和 CT 评分反映了疾病的阶段和病理变化,与实验室检查有适度的相关性,对疾病的诊断和监测有很好的价值。
感染 B.1.617.2 变异株的儿科患者的临床表现和影像学表现均较成人轻,与原型感染相似。
CT 表现和评分反映疾病阶段和病理变化。
胸部 CT 与实验室检查有相关性,有助于疾病的诊断和随访。