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肯尼亚两家私立医院儿童新冠肺炎的临床和流行病学概况

Clinical and epidemiological profiles of pediatric COVID-19 in two private Kenyan hospitals.

作者信息

Quadros Del-Rossi Sean, Shah Jasmit, Migowa Angela, Samia Pauline, Macharia William

机构信息

Department of Pediatrics and Child Health, Aga Khan University Hospital, Nairobi (AKUHN), Nairobi, Kenya.

Department of Internal Medicine, Aga Khan University Hospital, Nairobi (AKUHN), Nairobi, Kenya.

出版信息

Pan Afr Med J. 2024 Jun 7;48:48. doi: 10.11604/pamj.2024.48.48.39305. eCollection 2024.

Abstract

INTRODUCTION

COVID-19 infection has attracted global attention with limited published data on the burden in African children.

METHODS

hospital-based longitudinal survey in children with COVID-19 infection, aged 0-18 years admitted between August 2020 and December 2021. The main objective of the study was to describe socio-demographic, clinical and diagnostic manifestations of COVID-19 infection in children.

RESULTS

the study enrolled 85 children. Median age was 5•1 years (IQR = 1•3 - 12•4) with equal gender distribution. Under five years were 52•9%. Average length of hospital stay among non-severe cases was three days (IQR=2•0-5•0). No deaths were reported. Fifteen patients (18•7%) were asymptomatic. The most common presenting symptoms were fever (51•8%), vomiting (36•5%), cough (27•1%), diarrhea (20•0%), nasal congestion (14•1%) and fast breathing (12•9%). Two patients presented in shock and features consistent with Multisystemic Inflammatory Syndrome in Childhood (MIS-C). Procalcitonin and C-reactive proteins were elevated in 76•9% and 45•8% respectively. Majority (n=80) had white cell counts within normal range and none had bacterial pathogens isolated from blood (n=63). Liver and Renal function tests were within the normal range in the majority of those tested (n=24 and n=64 respectively). Three of the five patients with elevated platelet count (>500 x109/L) had clinical diagnosis of MIS-C. Eight of 20 patients subjected to imaging had radiological features of bilateral ground glass opacifications while six of nine patients who presented with cardiovascular compromise had mild to moderate ventricular dysfunction on echocardiography.

CONCLUSION

our study suggests that children in the African setting manifest a mild form of the COVID-19 infection with low mortality.

摘要

引言

新型冠状病毒肺炎(COVID-19)感染已引起全球关注,而关于非洲儿童感染负担的已发表数据有限。

方法

对2020年8月至2021年12月期间收治的0至18岁COVID-19感染儿童进行基于医院的纵向调查。该研究的主要目的是描述儿童COVID-19感染的社会人口统计学、临床和诊断表现。

结果

该研究纳入了85名儿童。中位年龄为5.1岁(四分位间距[IQR]=1.3 - 12.4),性别分布均衡。5岁以下儿童占52.9%。非重症病例的平均住院时间为3天(IQR=2.0 - 5.0)。无死亡报告。15名患者(18.7%)无症状。最常见的症状为发热(51.8%)、呕吐(36.5%)、咳嗽(27.1%)、腹泻(20.0%)、鼻塞(14.1%)和呼吸急促(12.9%)。2名患者出现休克以及与儿童多系统炎症综合征(MIS-C)相符的特征。降钙素原和C反应蛋白分别在76.9%和45.8%的患者中升高。大多数(n=80)患者白细胞计数在正常范围内,且无人从血液中分离出细菌病原体(n=63)。大多数接受检测的患者肝功能和肾功能检查均在正常范围内(分别为n=24和n=64)。血小板计数升高(>500×10⁹/L)的5名患者中有3名临床诊断为MIS-C。20名接受影像学检查的患者中有8名具有双侧磨玻璃影的放射学特征,而9名出现心血管功能障碍的患者中有6名在超声心动图检查中表现为轻度至中度心室功能障碍。

结论

我们的研究表明,非洲地区的儿童表现出COVID-19感染的轻度形式,死亡率较低。

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