PubMed Journals: Zhonghua Er Ke Za Zhi

  Source:		PMID: 32118389

    		Zhonghua Er Ke Za Zhi. 2020 Mar
     		2;58(4):E011. doi:
			[Epub ahead of print]

			[Clinical analysis of 31 cases of 2019 novel
			coronavirus infection in children from six
			provinces (autonomous region) of northern

			[Article in Chinese; Abstract available in Chinese
			from the publisher]

			Author Information
			(1) Department of Pediatric Internal Medicine,
			XI'an Children's Hospital, Xi'an 710003, China.
			(2) Department of Pediatric, Qilu Hospital of
			Shandong University, Jinan 250012, China.
			(3) Department of Pediatric, Department of
			Pediatrics, General Hospital of Ningxia
			University, Yinchuan 750004, China.
			(4) Department of Pediatric, the Fourth People's
			Hospital of Ningxia Hui Autonomous Region,
			Yinchuan 750000, China.
			(5) Department of Intensive Care Unit, Xi'an
			eighth hospital, Xi'an 710065, China.
			(6) Department of Infectious Diseases, Ankang
			Central Hospital, Ankang 725000, China.
			(7) Department of Pediatric, Tongchuan Mining
			Bureau Central Hospital, Tongchuan 727000,
			(8) Department of Respiratory Medicine, Yan'an
			Second People's Hospital Affiliated to Yan'an
			University, Yan'an 716000, China.
			(9) Department of Infectious Diseases, Lanzhou
			Pulmonology Hospital, Lanzhou 730046, China.
			(10) Department of Pediatric, Gansu Provincial
			Maternity and Child-Care Hospital, Lanzhou
			730050, China.
			(11) Department of Pediatric, Xianyang Central
			Hospital, Xianyang 712000, China.
			(12) Department of Respiratory Medicine,
			Children's Hospital of Zhengzhou University,
			Zhengzhou 450018, China.
			(13) Department of Pediatric Critical Care
			Medicine, Zhumadian Center Hospital,
			Zhumadian 463000, China.
			(14) Department of Pediatric, Shijiazhuang Fifth
			Hospital, Shijiazhuang 050024, China.
			(15) Department of Neonatal Intensive Care
			Unit, the Affiliated Children's Hospital of Xi'an
			Jiaotong University, Xi'an 710003, China.
			(16) Department of Pediatric,
			Tengzhou Central People's Hospital, Tengzhou
			277500, China.
			(17) Department of Pediatrics, Heze Municipal
			Hospital, Heze 274000, China.
			(18) Department of Pediatric, People's Hospital
			of Rizhao, Rizhao 276800, China.
			(19) Department of Infectious Diseases, Yantai
			Laiyang Central Hospital, Yantai 264000, China.
			(20) Department of Pediatric, Weihai Municipal
			Hospital, Weihai 264200, China.
			(21) Department of Infectious Diseases,
			People's Hospital of Pingliang City, Pingliang
			744000, China.

			Objective: To analyze the epidemiological
			history, clinical manifestations, treatment and
			the short-term prognosis of 31 cases of 2019
			novel coronavirus(2019-nCoV) infection in
			children from six provinces (autonomous region)
			in northern China. Methods: A retrospective
			analysis of the epidemiological history, clinical
			symptoms, signs, laboratory examinations,
			chest imaging, treatment and the short-term
			prognosis of 31 cases of 2019-nCoV was
			conducted. The patients were diagnosed
			between January 25th, 2020 and February
			21st, 2020 in 21 hospitals in 17 cities of six
			provinces(autonomous region) of Shaanxi,
			Gansu, Ningxia, Hebei, Henan and Shandong.
			Results: The age of the 31 children with
			2019-nCoV infection was 7 years and 1 month
			(6 months -17 years). Nine cases (29%) were
			imported cases. Other 21 cases (68%) had
			contact with confirmed infected adults. One
			case (3%) had contact with asymptomatic
			returnees from Wuhan. Among the 31 children,
			28 patients (90%) were family cluster cases.
			The clinical types were asymptomatic type in 4
			cases (13%), mild type in 13 cases (42%), and
			common type in 14 cases (45%). No severe or
			critical type existed. The most common
			symptom was fever (n=20, 65%), including 1
			case of high fever, 9 cases of moderate fever,
			10 cases of low fever. Fever lasted from 1 day
			to 9 days. The fever of fifteen cases lasted for ≤3
			d, while in other 5 cases lasted > 3 d. Other
			symptoms included cough (n=14, 45%), fatigue
			(n=3, 10%) and diarrhea (n=3, 9%).
			Pharyngalgia, runny nose, dizziness, headache
			and vomiting were rare. In the early stage, the
			total leukocytes count in peripheral blood
			decreased in 2 cases (6%), the lymphocytes
			count decreased in 2 cases (6%), and the
			platelet count increased in 2 cases
			(6%).Elevation of C-reactive protein (10%,
			3/30), erythrocyte sedimentation
			rate(19%,4/21), procalcitonin(4%,1/28), liver
			enzyme(22%, 6/27) and muscle enzyme (15%,
			4/27) occurred in different proportions. Renal
			function and blood glucose were normal. There
			were abnormal chest CT changes in 14 cases,
			including 9 cases with patchy ground glass
			opacities and nodules, mostly located in the
			lower lobe of both lungs near the pleural area.
			After receiving supportive treatment, the viral
			nucleic acid turned negative in 25 cases within
			7-23 days. Among them, 24 children (77%)
			recovered and were discharged from hospital.
			No death occurred. Conclusions: In this case
			series, 2019-nCoV infections in children from
			six provinces (autonomous region) in northern
			China are mainly caused by close family
			contact. Clinical types are asymptomatic, mild
			and common types. Clinical manifestations and
			laboratory examination results are nonspecific.
			Close contact history of epidemiology, nucleic
			acid detection and chest imaging are important
			bases for diagnosis. After general treatment,
			the short-term prognosis is good.

			Publisher: 目的: 分析中国北方6省(自治区)儿童2019新型冠状病毒(2019 novel coronavirus,
			2019-nCoV)感染者的流行病学史、临床表现、治疗及近期预后。 方法: 回顾性总结陕西、甘肃、宁夏、河北、河南、山东6省(自治区)于2020年1月25日至2020年2月21日经2019-nCoV核酸检测确诊的31例患儿的病例资料,分析 其流行病学史、临床症状、体征、实验室检查、胸部影像学以及治疗和近期预后情况。
			中28例(90%)为家庭聚集性发病。临床分型为无症状型4例(13%),轻型13例(42%),普通型14例(45%),无重型及危重型。症状发生频率最高为发热(20例 ,65%),其中高热1例、中度发热9例、低热10例,热程1~9
			d,5例>3 d;其余依次为咳嗽(14例,45%),乏力(3例,10%),腹泻(3例,10%),咽痛、流涕、头晕、头痛、呕吐等少见。早期外周血白细胞总数减少者、淋巴细胞数减少者 、血小板升高者各2例(6%)。C反应蛋白升高(10%,3/30),红细胞沉降率升高(19%,4/21),降钙素原升高(4%,1/28),血清转氨酶升高(22%,6 /27)及肌酶升高(15%,4/27)也有不同比例出现。肾功能及血糖检测均未见异常。14例患儿胸部CT有异常改变,其中9例呈斑片状磨玻璃阴影及结节,多位于双肺中外 带、近胸膜区。31例患儿给予一般治疗后25例核酸检测转阴(7~23 d),其中24例儿童(77%)痊愈出院,无死亡病例。 结论: 中国北方6省(自治区)031例儿童2019-nCoV感染以家庭内密切接触为主要感染途径,呈无症状型、轻型和普通型,临床表现及实验室检查结果无特异性。流行病学密切接 触史、核酸检测及胸部影像学是诊断的重要参考依据。给予一般治疗,近期预后整体良好。. DOI: 10.3760/cma.j.cn112140-20200225-00138
			PMID: 32118389

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