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新冠病毒肺炎儿童及青少年的临床表现:来自萨巴拉儿童医院的首批115例报告

CLINICAL MANIFESTATIONS OF CHILDREN AND ADOLESCENTS WITH COVID-19: REPORT OF THE FIRST 115 CASES FROM SABARÁ HOSPITAL INFANTIL.

作者信息

Rabha Anna Clara, Oliveira Junior Francisco Ivanildo de, Oliveira Thales Araújo de, Cesar Regina Grigolli, Fongaro Giuliana, Mariano Roberta Ferreira, Camargo Clarice Neves, Fernandes Fátima Rodrigues, Wandalsen Gustavo Falbo

机构信息

Instituto Pensi, Sabará Hospital Infantil, Fundação José Luiz Egydio Setúbal, São Paulo, SP, Brazil.

Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.

出版信息

Rev Paul Pediatr. 2020 Nov 27;39:e2020305. doi: 10.1590/1984-0462/2021/39/2020305. eCollection 2020.

Abstract

OBJECTIVE

To describe the clinical manifestations and severity of children and adolescents affected by COVID-19 treated at Sabará Hospital Infantil.

METHODS

This is a cross-sectional, retrospective, and observational study. All cases of COVID-19 confirmed by RT-qPCR of patients seen at the hospital (emergency room, first-aid room, and ICU) were analyzed. The severity of the cases was classified according to the Chinese Consensus.

RESULTS

Among the 115 children included, a predominance of boys (57%) was verified, and the median age was two years. A total of 22 children were hospitalized, 12 in the ICU. Of the total, 26% had comorbidities with a predominance of asthma (13%). Fever, cough, and nasal discharge were the most frequent symptoms. Respiratory symptoms were reported by 58% of children and gastrointestinal symptoms, by 34%. Three children were asymptomatic, 81 (70%) had upper airway symptoms, 15 (13%) had mild pneumonia, and 16 (14%) had severe pneumonia. Hospitalized children were younger than non-hospitalized children (7 months vs. 36 months). In hospitalized patients, a higher frequency of irritability, dyspnea, drowsiness, respiratory distress, low oxygen saturation, and hepatomegaly was observed. Chest radiography was performed in 69 children with 45% of abnormal exams. No child required mechanical ventilation and there were no deaths.

CONCLUSIONS

Most of children and adolescents affected by COVID-19 had mild upper airway symptoms. Clinical manifestations of COVID-19 were more severe among younger children who exhibited gastrointestinal and respiratory symptoms more frequently.

摘要

目的

描述在萨巴拉儿童医院接受治疗的感染新型冠状病毒肺炎(COVID-19)的儿童和青少年的临床表现及严重程度。

方法

这是一项横断面、回顾性观察研究。对在医院(急诊室、急救室和重症监护病房)就诊的患者经逆转录定量聚合酶链反应(RT-qPCR)确诊的所有COVID-19病例进行分析。根据中国专家共识对病例的严重程度进行分类。

结果

在纳入的115名儿童中,证实男孩占多数(57%),中位年龄为2岁。共有22名儿童住院,其中12名在重症监护病房。总体而言,26%的儿童有合并症,以哮喘为主(13%)。发热、咳嗽和流涕是最常见的症状。58%的儿童有呼吸道症状,34%有胃肠道症状。3名儿童无症状,81名(70%)有上呼吸道症状,15名(13%)有轻度肺炎,16名(14%)有重度肺炎。住院儿童比未住院儿童年龄小(7个月对36个月)。在住院患者中,观察到烦躁、呼吸困难、嗜睡、呼吸窘迫、低氧饱和度和肝肿大的发生率更高。69名儿童进行了胸部X线检查,其中45%的检查结果异常。没有儿童需要机械通气,也没有死亡病例。

结论

大多数感染COVID-19的儿童和青少年有轻度上呼吸道症状。COVID-19的临床表现在年龄较小的儿童中更为严重,这些儿童更频繁地出现胃肠道和呼吸道症状。

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