115例新型冠状病毒感染儿童的临床特点分析

Clinical features of children with SARS-CoV-2 infection: an analysis of 115 cases

摘要:

目的 研究儿童新型冠状病毒感染（SARS-CoV-2）的临床特点。方法 回顾性分析武汉儿童医院115例确诊SARS-CoV-2感染患儿的临床资料，包括一般情况、与确诊人群密切接触史、临床早期症状、实验室检查及肺部CT影像学检查结果等。结果 115例患儿中，男性73例（63.5%），女性42例（36.5%），男女比例为1：0.58。105例（91.3%）有明确的SARS-CoV-2感染者密切接触史。11例（9.6%）丙氨酸氨基转移酶增高，34例（29.6%）肌酸激酶同工酶增高。发热29例（25.2%），有呼吸道症状者（咳嗽、流涕、鼻塞等表现） 47例（40.9%），无症状感染者61例（53.0%）。49例（42.6%）肺部CT显示肺部存在磨玻璃样改变、纤维条索影、斑片状改变及肺部实变等表现，其中2例为“白肺”改变；39例（33.9%）仅表现为肺纹理增强；27例（23.5%）无肺部影像学改变。115例患儿中，3例为危重型，其中1例已治愈，另外2例在继续治疗中。结论 儿童SARS-CoV-2感染多有密切接触史；危重型病例少见；无症状感染比例较高。

Abstract:

Objective To study the clinical features of children with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Methods A retrospective analysis was performed for the clinical data of 115 children who were diagnosed with SARS-CoV-2 infection in the Wuhan Children's Hospital, including general information, history of close contact with individuals of SARS-CoV-2 infection, early clinical symptoms, laboratory examination results, and lung CT results. Results Among the 115 children, there were 73 boys (63.5%) and 42 girls (36.5%), with a male/ female ratio of 1:0.58. Of the 115 children, 105 (91.3%) had a definite history of close contact with individuals of SARSCoV-2-infection. An increase in alanine aminotransferase was observed in 11 children (9.6%) and an increase in CK-MB was found in 34 children (29.6%). As for clinical symptoms, 29 children (25.2%) had fever, 47 (40.9%) had respiratory symptoms (including cough, rhinorrhea, and nasal congestion), and 61 (53.0%) were asymptomatic. Lung CT findings showed ground glass opacity, fiber opacities, patchy changes, and pulmonary consolidation in 49 children (42.6%), among whom 2 children had “white lung”; 39 children (33.9%) only had lung texture enhancement and 27 children (23.5%) had no pulmonary imaging changes. Among the 115 children, 3 were critically ill, among whom 1 had been cured and the other 2 were under continuous treatment. Conclusions Most of the children with SARS-CoV-2 infection have a close contact history. Critical cases are rare and there is a high proportion of asymptomatic infection.