A single-center, retrospective study of COVID-19 features in children: a descriptive investigation
| Autor: | Wei Chen, Rafael Ramos, Hui Li, Luke D Wesemann, Xi Zhou, Baiqi Zhu, Jianbo Shao, Jun Xia, Maxwell T. Laws, Huijing Ma, Jiani Hu, Jie Tian |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
Lymphocytosis Epidemiology lcsh:Medicine Single Center Disease Outbreaks 0302 clinical medicine Reference Values 030212 general & internal medicine Child Children Lung Fisher's exact test Pediatric General Medicine COVID-19 Computerized tomography Clinical features SARS-CoV-2 Coronavirus Child Preschool symbols Female Radiology medicine.symptom Coronavirus Infections Research Article medicine.medical_specialty China Pneumonia Viral Real-Time Polymerase Chain Reaction Lesion 03 medical and health sciences symbols.namesake Betacoronavirus 030225 pediatrics medicine Humans Pandemics Retrospective Studies Thrombocytosis business.industry lcsh:R Retrospective cohort study medicine.disease Pneumonia business Tomography X-Ray Computed |
| Zdroj: | BMC medicine, 18(1):123 BMC Medicine BMC Medicine, Vol 18, Iss 1, Pp 1-11 (2020) |
| Popis: | BackgroundCompared to adults, there are relatively few studies on COVID-19 infection in children, and even less focusing on the unique features of COVID-19 in children in terms of laboratory findings, locations of computerized tomography (CT) lesions, and the role of CT in evaluating clinical recovery. The objective of this study is to report the results from patients at Wuhan Children’s Hospital, located within the initial center of the outbreak.MethodsClinical, imaging, and laboratory data of 76 children were collected retrospectively and analyzed with the Fisher exact test and Cox regression statistical methods.ResultsAmong 50 children with a positive COVID-19 real-time reverse-transcriptase polymerase chain reaction (PCR), five had negative PCR results initially but showed positive results in subsequent tests. Eight (16%) patients had lymphopenia, seven (14%) with thrombocytopenia, four (8%) with lymphocytosis, two (4%) with thrombocytosis, ten (20%) with elevated C-reactive protein, four (8%) with hemoglobin above, and six (12%) with below standard reference values. Seven (14%) of the 50 had no radiologic evidence of disease on chest CT. For the 43 patients who had abnormal CT findings, in addition to previously reported patterns of ground-glass opacity (67%), local patchy shadowing (37%), local bilateral patchy shadowing (21%), and lesion location of lower lobes (65%), other CT features include that an overwhelming number of pediatric patients had lesions in the subpleural area (95%) and 22 of the 28 lower lobe lesions were in the posterior segment (78%). Lesions in most of the 15 patients (67%) who received chest CT at discharge were not completely absorbed, and 26% of these pediatric patients had CT lesions that were either unchanged or worse.ConclusionsThere were a few differences between COVID-19 children and COVID-19 adults in terms of laboratory findings and CT characteristics. CT is a powerful tool to detect and characterize COVID-19 pneumonia but has little utility in evaluating clinical recovery for children. These results oppose current COVID-19 hospital discharge criteria in China, as one requirement is that pulmonary imaging must show significant lesion absorption prior to discharge. These differences between pediatric and adult cases of COVID-19 may necessitate pediatric-specific discharge criteria. |
| Databáze: | OpenAIRE |
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