Our official English website, www.x-mol.net, welcomes your
feedback! (Note: you will need to create a separate account there.)
Clinical characteristics of 182 pediatric COVID‐19 patients with different severities and allergic status
Allergy ( IF 12.6 ) Pub Date : 2020-09-03 , DOI: 10.1111/all.14452 Hui Du 1 , Xiang Dong 2 , Jin-Jin Zhang 2 , Yi-Yuan Cao 3 , Mubeccel Akdis 4 , Pei-Qi Huang 1 , Hong-Wei Chen 1 , Ying Li 1 , Guang-Hui Liu 2 , Cezmi A Akdis 4 , Xiao-Xia Lu 1 , Ya-Dong Gao 2
Allergy ( IF 12.6 ) Pub Date : 2020-09-03 , DOI: 10.1111/all.14452 Hui Du 1 , Xiang Dong 2 , Jin-Jin Zhang 2 , Yi-Yuan Cao 3 , Mubeccel Akdis 4 , Pei-Qi Huang 1 , Hong-Wei Chen 1 , Ying Li 1 , Guang-Hui Liu 2 , Cezmi A Akdis 4 , Xiao-Xia Lu 1 , Ya-Dong Gao 2
Affiliation
|
Abstract Background The pandemic of coronavirus disease 2019 (COVID‐19) caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection has made widespread impact recently. We aim to investigate the clinical characteristics of COVID‐19 children with different severities and allergic status. Methods Data extracted from the electronical medical records, including demographics, clinical manifestations, comorbidities, laboratory and immunological results and radiological images of 182 hospitalized COVID‐19 children were summarized and analyzed. Results The median age was 6 years old, ranging from 3 days to 15 years, and there were more boys (male‐female ratio about 2:1) within the studied 182 patients. Most of the children were infected by family members. Fever (43.4%) and dry cough (44.5%) were common symptoms, and gastrointestinal manifestations accounted for 11.0%, including diarrhea, abdominal discomfort and vomiting. 71.4% had abnormal chest computed tomography (CT) scan images, and typical signs of pneumonia were ground‐glass opacity and local patchy shadowing on admission. Laboratory results were mostly within normal ranges, and only a small ratio of lymphopenia (3.9%) and eosinopenia (29.5%) were observed. The majority (97.8%) of infected children were not severe, and 24 (13.2%) of them had asymptomatic infections. Compared to children without pneumonia(manifested as asymptomatic and acute upper respiratory infection), children with pneumonia were associated with higher percentages of the comorbidity history, symptoms of fever and cough, and increased levels of serum procalcitonin, alkaline phosphatase and serum interleukins (IL)‐2, IL‐4, IL‐6, IL‐10 and TNF‐α.There were no differences of treatments, duration of hospitalization, time from first positive to first negative nucleic acid testing and outcomes between children with mild pneumonia and without pneumonia. All the hospitalized COVID‐19 children had recovered except one death due to intussusception and sepsis. In 43 allergic children with COVID‐19, allergic rhinitis (83.7%) was the major disease, followed by drug allergy, atopic dermatitis, food allergy and asthma. Demographics and clinical features were not significantly different between allergic and non‐allergic groups. Allergic patients showed less increase in acute phase reactants, procalcitonin, D‐dimer and aspartate aminotransferase levels compared to all patients. Immunological profiles including circulating T, B and NK lymphocyte subsets, total immunoglobulin and complement levels and serum cytokines did not show any difference in allergic and pneumonia groups. Neither eosinophil counts nor serum total immunoglobulin E (IgE) levels showed a significant correlation with other immunological measures, such as other immunoglobulins, complements, lymphocyte subsets numbers and serum cytokine levels. Conclusion Pediatric COVID‐19 patients tended to have a mild clinical course. Patients with pneumonia had higher proportion of fever and cough and increased inflammatory biomarkers than those without pneumonia. There was no difference between allergic and non‐allergic COVID‐19 children in disease incidence, clinical features, laboratory and immunological findings. Allergy was not a risk factor for developing and severity of SARS‐CoV‐2 infection and hardly influenced the disease course of COVID‐19 in children.
中文翻译：
182 例不同严重程度和过敏状态的儿科 COVID-19 患者的临床特征
摘要背景 由严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 感染引起的 2019 年冠状病毒病 (COVID-19) 大流行最近产生了广泛影响。我们旨在调查具有不同严重程度和过敏状态的 COVID-19 儿童的临床特征。方法 对从电子病历中提取的数据，包括 182 名 COVID-19 住院儿童的人口统计学、临床表现、合并症、实验室和免疫学结果以及放射图像等数据进行总结和分析。结果研究的182例患者中位年龄为6岁，从3天到15岁不等，男孩较多（男女比例约为2：1）。大多数孩子是由家庭成员感染的。发热（43.4%）和干咳（44.5%）是常见症状，胃肠道表现占11.0%，包括腹泻、腹部不适和呕吐。71.4% 的胸部计算机断层扫描 (CT) 扫描图像异常，肺炎的典型体征是入院时毛玻璃样混浊和局部斑片状阴影。实验室结果大多在正常范围内，仅观察到少量淋巴细胞减少（3.9%）和嗜酸性粒细胞减少（29.5%）。大部分（97.8%）感染儿童不严重，其中24名（13.2%）无症状感染者。与没有肺炎的儿童（表现为无症状和急性上呼吸道感染）相比，肺炎儿童的合并症、发热和咳嗽症状的比例更高，血清降钙素原、碱性磷酸酶和血清白细胞介素（IL）水平升高-2、IL-4、IL-6、IL-10和TNF-α。轻度肺炎患儿与非肺炎患儿的治疗、住院时间、核酸检测首次阳性到首次阴性时间及结局均无差异。除一名因肠套叠和败血症而死亡外，所有住院的 COVID-19 儿童均已康复。在 43 名 COVID-19 过敏儿童中，过敏性鼻炎（83.7%）是主要疾病，其次是药物过敏、特应性皮炎、食物过敏和哮喘。过敏和非过敏组之间的人口统计学和临床特征没有显着差异。与所有患者相比，过敏患者的急性期反应物、降钙素原、D-二聚体和天冬氨酸氨基转移酶水平的增加较少。免疫学特征，包括循环 T、B 和 NK 淋巴细胞亚群，总免疫球蛋白和补体水平以及血清细胞因子在过敏组和肺炎组中没有显示出任何差异。嗜酸性粒细胞计数和血清总免疫球蛋白 E (IgE) 水平均未显示与其他免疫学指标（如其他免疫球蛋白、补体、淋巴细胞亚群数量和血清细胞因子水平）显着相关。结论 儿科 COVID-19 患者的临床病程较轻。与没有肺炎的患者相比，肺炎患者的发热和咳嗽比例更高，炎症生物标志物增加。在发病率、临床特征、实验室和免疫学发现方面，过敏性和非过敏性 COVID-19 儿童之间没有差异。
更新日期：2020-09-03
中文翻译：
182 例不同严重程度和过敏状态的儿科 COVID-19 患者的临床特征
摘要背景 由严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 感染引起的 2019 年冠状病毒病 (COVID-19) 大流行最近产生了广泛影响。我们旨在调查具有不同严重程度和过敏状态的 COVID-19 儿童的临床特征。方法 对从电子病历中提取的数据，包括 182 名 COVID-19 住院儿童的人口统计学、临床表现、合并症、实验室和免疫学结果以及放射图像等数据进行总结和分析。结果研究的182例患者中位年龄为6岁，从3天到15岁不等，男孩较多（男女比例约为2：1）。大多数孩子是由家庭成员感染的。发热（43.4%）和干咳（44.5%）是常见症状，胃肠道表现占11.0%，包括腹泻、腹部不适和呕吐。71.4% 的胸部计算机断层扫描 (CT) 扫描图像异常，肺炎的典型体征是入院时毛玻璃样混浊和局部斑片状阴影。实验室结果大多在正常范围内，仅观察到少量淋巴细胞减少（3.9%）和嗜酸性粒细胞减少（29.5%）。大部分（97.8%）感染儿童不严重，其中24名（13.2%）无症状感染者。与没有肺炎的儿童（表现为无症状和急性上呼吸道感染）相比，肺炎儿童的合并症、发热和咳嗽症状的比例更高，血清降钙素原、碱性磷酸酶和血清白细胞介素（IL）水平升高-2、IL-4、IL-6、IL-10和TNF-α。轻度肺炎患儿与非肺炎患儿的治疗、住院时间、核酸检测首次阳性到首次阴性时间及结局均无差异。除一名因肠套叠和败血症而死亡外，所有住院的 COVID-19 儿童均已康复。在 43 名 COVID-19 过敏儿童中，过敏性鼻炎（83.7%）是主要疾病，其次是药物过敏、特应性皮炎、食物过敏和哮喘。过敏和非过敏组之间的人口统计学和临床特征没有显着差异。与所有患者相比，过敏患者的急性期反应物、降钙素原、D-二聚体和天冬氨酸氨基转移酶水平的增加较少。免疫学特征，包括循环 T、B 和 NK 淋巴细胞亚群，总免疫球蛋白和补体水平以及血清细胞因子在过敏组和肺炎组中没有显示出任何差异。嗜酸性粒细胞计数和血清总免疫球蛋白 E (IgE) 水平均未显示与其他免疫学指标（如其他免疫球蛋白、补体、淋巴细胞亚群数量和血清细胞因子水平）显着相关。结论 儿科 COVID-19 患者的临床病程较轻。与没有肺炎的患者相比，肺炎患者的发热和咳嗽比例更高，炎症生物标志物增加。在发病率、临床特征、实验室和免疫学发现方面，过敏性和非过敏性 COVID-19 儿童之间没有差异。
京公网安备 11010802027423号