Emergency Department, Hospital Universitario Gregorio Marañón and Foundation for Biomedical Research of Hospital Universitario Gregorio Marañón, Madrid.
Pediatric Emergency Department, Hospital Universitari Vall d'Hebron, Barcelona.
Pediatr Emerg Care. 2023 Feb 1;39(2):102-107. doi: 10.1097/PEC.0000000000002897. Epub 2023 Jan 8.
The first cases of infection by SARS-CoV-2 in the Spanish pediatric population were reported on early March 2020. Although most were mild or asymptomatic, new forms of clinical presentation and severity were reported with the evolution of the pandemic. We aimed to describe demographics, clinical features, and management of children with COVID-19 treated in Spanish emergency departments (EDs).
A multicenter registry including 15 pediatric EDs was carried out. Patients younger than 18 years with confirmed acute SARS-CoV2 infection diagnosed between March and August 2020 were included.
Three hundred ninety-five patients were analyzed (median age, 4.3 years). Fifty-five (13.9%) had comorbidities, and 141 (35.7%) a household contact with confirmed COVID-19. The most reported symptoms were fever (85.2%) and cough (41.7%). Fifty (12.5%) were asymptomatic. Seventeen (4.9%) were not well-appearing at presentation. Children underwent a blood test in 26.7% and a chest X-ray in 21.4%; findings were often unremarkable. Symptomatic treatment was prescribed to 80%; 6 (1.7%) received antiviral treatment. Seventy-one (20.6%) were hospitalized, and 3 (0.9%) were admitted to the intensive care unit; no patient died. The main clinical diagnoses were fever without a source (38%) and upper respiratory tract infection (32.2%); 4 (1.1%) presented a multisystem inflammatory syndrome.
Most pediatric COVID-19 cases in EDs during the first months of the pandemic were healthy, well-appearing children, presenting with fever +/- respiratory symptoms. In a significant number of cases, there was household transmission. Most children were managed as outpatients with symptomatic treatment, being exceptional the evolution to a serious illness.
西班牙儿科人群中首例 SARS-CoV-2 感染病例于 2020 年 3 月初报告。尽管大多数病例为轻症或无症状，但随着大流行的发展，报告了新的临床表型和严重程度。我们旨在描述在西班牙急诊室（ED）治疗的 COVID-19 患儿的人口统计学、临床特征和管理方法。
进行了一项包括 15 个儿科 ED 的多中心登记研究。纳入 2020 年 3 月至 8 月间确诊的急性 SARS-CoV2 感染且年龄小于 18 岁的患儿。
共分析了 395 例患儿（中位年龄 4.3 岁）。55 例（13.9%）有合并症，141 例（35.7%）有与确诊 COVID-19 患者的家庭接触史。最常见的症状是发热（85.2%）和咳嗽（41.7%）。50 例（12.5%）为无症状。17 例（4.9%）就诊时表现不佳。26.7%的患儿行血液检查，21.4%的患儿行胸部 X 线检查；结果通常无明显异常。80%的患儿给予对症治疗；6 例（1.7%）接受抗病毒治疗。71 例（20.6%）住院，3 例（0.9%）收入重症监护病房；无患儿死亡。主要临床诊断为原因不明发热（38%）和上呼吸道感染（32.2%）；4 例（1.1%）表现为多系统炎症综合征。
大流行最初几个月，急诊室收治的大多数 COVID-19 患儿为健康、表现良好的发热伴/不伴呼吸道症状的儿童。在很大比例的病例中，存在家庭内传播。大多数患儿接受门诊对症治疗，极少数患儿进展为严重疾病。
