Infection characteristics of 11 juvenile cases of COVID-19 in BoZhou City, Anhui Province
-
摘要:
目的 研究安徽省亳州市新型冠状病毒肺炎(COVID-19)0~17岁未成年人患者的流行病学特征及临床特点。 方法 本项回顾性研究纳入了11例安徽省亳州市2020年1月24日—2月12日收治的所有未成年人确诊病例,并进行流行病学、临床、放射学特征及实验室数据分析。 结果 11名COVID-19未成年人患者年龄中位数为10.54(7.50, 13.00)岁,其中男6例,女5例。所有患者均经RT-PCR检测到新型冠状病毒(SARS-Cov-2),均至少有1名家人感染了SARS-Cov-2。4例(36.3%)患者出现发热,8例(72.7%)患者出现轻度上呼吸道感染症状,包括2例(18.2%)咳嗽,1例(9.1%)肌肉疼痛,2例(18.2%)咽喉痛,4例(36.4%)出现鼻塞、流涕,1例(9.1%)在确诊COVID-19前1~2 d表现出明显的胃肠道症状等临床表现。8例患者(72.7%)出现淋巴细胞计数减少,9例(81.8%)患者的C反应蛋白升高,3例(27.2%)患者的ALT和AST升高,4例患者(36.4%)的白细胞计数正常。影像学检查显示,3例(27.2%)患者出现双侧肺炎,5例(45.5%)患者表现为多发性斑点和磨玻璃样特征。 结论 与成人相比,目前未成年人病例不多,相关研究还不充足,以上资料为本次疫情的有效防控和精准救治提供了宝贵的指导意见。 Abstract:Objective To study the epidemiological and clinical characteristics of juvenile patients with coronavirus disease 2019 (COVID-19) in BoZhou City, Anhui Province. Methods We conducted a retrospective study focusing on 11 juvenile patients diagnosed with COVID-19 in BoZhou City, Anhui Province from 24 January 2020 to 12 February 2020. Epidemiological, demographic, clinical, laboratory, radiological and treatment data were collected and analysed. Results Amongst the hospitalised juvenile patients with COVID-19, the median age was 10.54(7.5, 13.0) years, and 6(54.5%) were male. All 11 patients were detected by real-time RT-PCR, and at least 1 family members were infected with COVID-19. Patients had clinical manifestations of fever [4(36.3)% patients], mild upper respiratory tract symptoms [8(72.7%) patients], cough [2(18.2%) patients], muscle ache [1(9.1%) patients], sore throat [2(18.2%) patients] and nasal congestion [4(36.4%) patients]. One patient (9.1%) showed significant gastrointestinal symptoms and other clinical manifestations 1-2 days before the diagnosis of COVID-19. Eight patients (72.7%) had decreased lymphocyte counts, 9(81.8%) had elevated c-reactive protein levels, 3(27.2%) had elevated ALT and AST, and 4(36.4%) had normal white blood cell counts. According to imaging examination, 3(27.2%) patients showed bilateral pneumonia, and 5(45.5%) patients showed multiple mottling and ground-glass opacity. Conclusion Compared with adults, there are not many cases of juvenile patients, and relevant studies are insufficient. The above information provides valuable guidance for the effective management and accurate treatment of this disease. -
Key words:
- Juvenile /
- Coronavirus disease 2019 /
- Prevention and control
-
表 1 11例COVID-19未成年患者的临床表现和相关实验室结果
Table 1. Clinical manifestations and related laboratory examinations of 11 juvenile cases of COVID-19
项目 数值 年龄[M(P25, P75), 年] 10.54(7.50, 13.00) 发热天数[M(P25, P75), d] 5.36(4.81, 10.23) 体温[M(P25, P75), ℃] 37.6(36.4, 38.6) 从入院到确诊的时间[M(P25, P75), d] 2.23(1.51, 3.46) 咳嗽天数[M(P25, P75), d] 5.33(4.68, 11.89) 咳嗽[例(%)] 2(18.2) 咽喉痛[例(%)] 2(18.2) 鼻塞伴流涕[例(%)] 4(36.4) 肌肉疼痛[例(%)] 1(9.1) 腹泻[例(%)] 1(9.1) 上呼吸道症状[例(%)] 8(72.7) 头痛[例(%)] 3(27.2) 家庭成员感染[例(%)] 11(100.0) 与武汉的联系[例(%)] 3(27.2) C反应蛋白(mg/L) 11.80 (6.20, 13.05) 血红蛋白(mg/L) 127.00(121.00, 132.00) 血细胞比容(%) 42.20(36.00,46.05) 血小板(×109/L) 281.00(222.50, 304.50) 白细胞(×109/L) 5.84(4.96, 6.35) 淋巴细胞(%) 31.60(27.20, 35.10) 淋巴细胞计数(×109/L) 0.77(0.73, 2.40) 中性粒细胞百分比(%) 57.90(42.90,58.95) 中性粒细胞计数(×109/L) 2.81(2.05, 3.12) 嗜酸性粒细胞比值(%) 2.10(1.60,2.35) 嗜酸性粒细胞计数(×109/L) 0.10(0.08, 0.14) 嗜碱性粒细胞比值(%) 0.30(0.20,0.35) 嗜碱性粒细胞计数(×109/L) 0.01(0.01, 0.02) 单核细胞百分比(%) 6.90(5.80,7.60) 单核细胞计数(×109/L) 0.37(0.31, 0.41) 降钙素原(%) 0.24(0.19,0.30) 谷丙转氨酶ALT(U/L) 12.00(9.90, 39.36) 谷草转氨酶AST(U/L) 25.20(16.8, 37.58) -
[1] 中华预防医学会新型冠状病毒肺炎防控专家组. 新型冠状病毒肺炎流行病学特征的最新认识[J]. 中国病毒病杂志, 2020, 10(2): 86-92. https://www.cnki.com.cn/Article/CJFDTOTAL-ZRYX202002002.htmSpecial Expert Group for Control of the Epidemic of Novel Coronavirus Pneumonia of the Chinese Preventive Medicine Association. An update on the epidemiological characteristics of novel coronavirus pneumonia(COVID-19)[J]. Chinese Journal of Viral Diseases, 2020, 10(2): 86-92. https://www.cnki.com.cn/Article/CJFDTOTAL-ZRYX202002002.htm [2] WANG D W, HU B, HU C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China[J]. JAMA, 2020, 323(11): 1061-1069. doi: 10.1001/jama.2020.1585 [3] CHANG D, LIN M G, WEI L, et al. Epidemiologic and clinical characteristics of novel coronavirus infections involving 13 patients outside Wuhan, China[J]. JAMA, 2020, 323(11): 1092-1093. doi: 10.1001/jama.2020.1623 [4] 缪莎, 罗稀, 王左, 等. 重症病区新型冠状病毒肺炎患者心理状况及影响因素分析[J]. 徐州医科大学学报, 2020, 40(8): 612-616. doi: 10.3969/j.issn.2096-3882.2020.08.015MIAO S, LUO X, WANG Z, et al. Analysis of psychological status and influencing factors of COVID-19 patients in the intensive care unit[J]. Journal of Xuzhou Medical University, 2020, 40(8): 612-616. doi: 10.3969/j.issn.2096-3882.2020.08.015 [5] 蔡洁皓, 王相诗, 葛艳玲, 等. 上海首例儿童新型冠状病毒感染[J]. 中华儿科杂志, 2020, 58(2): 86-87. doi: 10.3760/cma.j.issn.0578-1310.2020.02.002CAI J H, WANG X S, GE Y L, et al. First case of 2019 novel coronavirus infection in children in Shanghai[J]. Chinese Journal of Pediatrics, 2020, 58(2): 86-87. doi: 10.3760/cma.j.issn.0578-1310.2020.02.002 [6] 国家卫生健康委办公厅国家中医药管理局办公室. 关于印发新型冠状病毒肺炎诊疗方案(试行第六版)的通知[EB/OL]. (2020-02-18)[2020-09-11]. http://bgs.satcm.gov.cn/zhengcewenjian/2020-02-19/13221.html.General Office of the National Health Commission and office of the State Administration of Traditional Chinese Medicine. Notice on the diagnosis and treatment of new coronavirus pneumonia (trial version sixth)[EB/OL]. (2020-02-18)[2020-09-11]. http://bgs.satcm.gov.cn/zhengcewenjian/2020-02-19/13221.html. [7] 牛永亮, 时靖峰, 腾小宝, 等. 100例新型冠状病毒感染者临床病例分析[J]. 川北医学院学报, 2020, 35(3): 547-550. doi: 10.3969/j.issn.1005-3697.2020.03.049NIU Y L, SHI J F, TENG X B, et al. Analysis on clinical characteristics of 100 patients with novel coronavirus[J]. Journal of North Sichuan Medical College, 2020, 35(3): 547-550. doi: 10.3969/j.issn.1005-3697.2020.03.049 [8] 冯凯, 云永兴, 王险峰, 等. 儿童2019新型冠状病毒感染15例CT影像特征分析[J]. 中华儿科杂志, 2020, 58(4): 275-278. doi: 10.3760/cma.j.cn112140-20200210-00071FENG K, YUN Y X, WANG X F, et al. Analysis of CT features of 15 children with 2019 novel coronavirus infection[J]. Chinese Journal of Pediatrics, 2020, 58(4): 275-278. doi: 10.3760/cma.j.cn112140-20200210-00071 [9] 杨斌斌, 朱月玲. 儿童与成人新型冠状病毒肺炎的流行病学与治疗现状分析[J]. 西安交通大学学报(医学版), 2020, 41(4): 483-487. https://www.cnki.com.cn/Article/CJFDTOTAL-XAYX202004003.htmYANG B B, ZHU Y L. Epidemiology and treatment of novel coronavirus pneumonia in children and adults[J]. Journal of Xi ' an Jiaotong University(Medical Sciences), 2020, 41(4): 483-487. https://www.cnki.com.cn/Article/CJFDTOTAL-XAYX202004003.htm [10] PEERI N C, SHRESTHA N, RAHMAN M S, et al. The SARS, MERS and novel coronavirus (COVID-19) epidemics, the newest and biggest global health threats: What lessons have we learned?[J]. Int J Epidemiol, 2020, 49(3): 717-726. doi: 10.1093/ije/dyaa033 [11] DEL RIO C, MALANI P N. 2019 novel coronavirus: Important information for clinicians[J]. JAMA, 2020, 323(11): 1039-1040. doi: 10.1001/jama.2020.1490 [12] KUMAR V, TAN K P, WANG Y M, et al. Identification, synthesis and evaluation of SARS-CoV and MERS-CoV 3C-like protease inhibitors[J]. Bioorg Med Chem, 2016, 24(13): 3035-3042. doi: 10.1016/j.bmc.2016.05.013 [13] 陈苗, 张旺生, 江光煚, 等. 襄阳市1 175例新型冠状病毒肺炎确诊病例流行病学特征分析[J]. 公共卫生与预防医学, 2020, 31(6): 15-18. doi: 10.3969/j.issn.1006-2483.2020.06.004CHEN M, ZHANG W S, JIANG G G, et al. Epidemiological characteristics of 1 175 confirmed cases of COVID-19 in Xiangyang[J]. Journal of Public Health and Preventive Medicine, 2020, 31(6): 15-18. doi: 10.3969/j.issn.1006-2483.2020.06.004 [14] 王巧凤, 杨艳霞, 李阳, 等. 玉溪14例新型冠状病毒肺炎患者的回顾性分析[J]. 云南医药, 2020, 41(6): 529-533. https://www.cnki.com.cn/Article/CJFDTOTAL-YNYY202006002.htm [15] ABDIRIZAK F, LEWIS R, CHOWELL G. Evaluating the potential impact of targeted vaccination strategies against severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) outbreaks in the healthcare setting[J]. Theor Biol Med Mode, 2019, 16(1): 16. doi: 10.1186/s12976-019-0112-6 [16] YOON S H, LEE K H, KIM J Y, et al. Chest radiographic and CT Findings of the 2019 novel coronavirus disease (COVID-19): Analysis of nine patients treated in Korea[J]. Korean J Radiol, 2020, 21(4): 494-500. doi: 10.3348/kjr.2020.0132 [17] RYU S, CHUN B C. An interim review of the epidemiological characteristics of 2019 novel coronavirus[J]. Epidemiol Health, 2020, 42: e2020006. doi: 10.4178/epih.e2020006 [18] 任洪伟, 安维民, 董景辉, 等. 新型冠状病毒肺炎临床表现与影像学特征分析[J]. 中国临床医学, 2020, 27(3): 369-372. https://www.cnki.com.cn/Article/CJFDTOTAL-LCYX202003007.htmREN H W, AN W M, DONG J H, et al. Clinical and CT imaging features of COVID-19[J]. Chinese Journal of Clinical Medicine, 2020, 27(3): 369-372. https://www.cnki.com.cn/Article/CJFDTOTAL-LCYX202003007.htm [19] 方峰, 罗小平. 面对2019新型冠状病毒感染重大疫情: 儿科医生的思考[J]. 中华儿科杂志, 2020, 58(2): 81-85. doi: 10.3760/cma.j.issn.0578-1310.2020.02.001FANG F, LUO X P. Facing the pandemic of 2019 novel coronavirus infections: the pediatric perspectives[J]. Chinese Journal of Pediatrics, 2020, 58(2): 81-85. doi: 10.3760/cma.j.issn.0578-1310.2020.02.001 [20] 刘苗, 万曦, 涂晓燕, 等. 一起家庭聚集性儿童感染新型冠状病毒分析[J]. 武汉大学学报(医学版), 2020, 41(3): 362-365. https://www.cnki.com.cn/Article/CJFDTOTAL-HBYK202003005.htmLIU M, WAN X, TU X Y, et al. Family cluster of child SARS-CoV-2 infections: A case report[J]. Medical Journal of Wuhan University, 2020, 41(3): 362-365. https://www.cnki.com.cn/Article/CJFDTOTAL-HBYK202003005.htm [21] 钟霞, 李伟, 郭德莹, 等. COVID-19流行期间非定点收治三级综合医院感染防控实践的探索[J]. 中华全科医学, 2020, 18(12): 2117-2119, 2148. doi: 10.16766/j.cnki.issn.1674-4152.001702ZHONG X, LI W, GUO D Y, et al. Practice of infection prevention and control in non-designated three grade general hospital during COVID-19 epidemic period[J]. Chinese Journal of General Practice, 2020, 18(12): 2117-2119, 2148. doi: 10.16766/j.cnki.issn.1674-4152.001702 -