Clinical characteristics of 146 children with 2019 novel coronavirus infection in Wuhan City / 中华传染病杂志

ABSTRACT

Objective:To investigate the clinical manifestations and characteristics of children infected with 2019 novel coronavirus (2019-nCoV) in Wuhan City.Methods:The clinical data of 146 children diagnosed with 2019 novel coronavirus infection by nasopharyngeal swab real-time reverse transcription polymerase chain reaction in Wuhan Children′s Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 21 to February 24, 2020 were retrospectively analyzed. The basic data, clinical symptoms, laboratory examinations, pulmonary imaging, clinical classification, treatment medication and the prognosis of disease were included for analysis.Results:Among the 146 cases, 86 (58.9%) were males and 60 (41.1%) were females, with a median age of 6 years and 10 months.Three cases (2.1%) had a history of underlying diseases, 127 cases (87.0%) had a clear history of infected family clusters, and two cases (1.4%) had a history of exposure with Huanan Seafood Wholesale Market in Wuhan City. The clinical classifications included 20 asymptomatic cases (13.7%), 26 mild cases (17.8%), 99 ordinary cases (67.8%), and one critical case (0.7%). A total of 146 patients were tested positive for nasopharyngeal swabs by 2019-nCoV nucleic acid. Among them, 10 patients had a negative nasopharyngeal swab nucleic acid test before diagnosis, and one of them had a negative nasopharyngeal swab nucleic acid test for two consecutive times. The initial symptoms were mainly fever (59 cases, 40.4%) and cough (52 cases, 35.6%). Thirteen cases (8.9%) showed decreased leukocyte counts and three cases (2.1%) showed decreased lymphocyte counts. In addition, aspartate aminotransferase increased in 23 cases (15.8%), serum creatinine increased in seven cases (4.8%), lactic acid dehydrogenase increased in 26 cases (17.8%), and C reactive protein increased in 38 cases (26.0%). Fifty-nine cases (40.4%) were tested positive for IgM antibody to Mycoplasma pneumoniae. One hundred cases (68.5%) were abnormal in pulmonary imaging and 50 cases (34.2%) presented with multiple frosted glass shadows. All the 146 children were given general treatment, and the antiviral treatment was mainly interferon or interferon combined with oral medication. As of February 24, 2020, 72 cases (49.3%) were discharged from the hospital after reaching the de-isolation standard, with a median length of stay of 10 days, and there was no death case.Conclusions:Children with 2019-nCoV infection in Wuhan City are mainly caused by family aggregation. The clinical classification is mainly ordinary type, and the laboratory examination has no specificity. Specimens could be collected from multiple repeatable sites for 2019-nCoV nucleic acid test in suspected cases. Chest computed tomography has certain value for the diagnosis of children with 2019-nCoV infection. The recent prognosis of the patients is good with general treatment.