无症状或亚临床感染的COVID-19儿童临床特征分析  

Clinical features of asymptomatic or subclinical COVID-19 in children

作　　者：刘优靖 陈鹏[1] 刘智胜[1] 李颖[1] 杜慧 徐佳莉[1] LIU You-Jing;CHEN Peng;LIU Zhi-Sheng;LI Ying;DU Hui;XU Jia-Li(Department of Respiratory Medicine,Wuhan Children's Hospital/Wuhan Maternal and Child Healthcare Hospital,Tongji Medical College,Huazhong University of Science&Technology,Wuhan 430016,China)

机构地区：[1]华中科技大学同济医学院附属武汉儿童医院/武汉市妇幼保健院呼吸内科,湖北武汉430016

出　　处：《中国当代儿科杂志》2020年第6期578-582,共5页Chinese Journal of Contemporary Pediatrics

摘　　要：目的分析无症状或亚临床感染的2019冠状病毒病(COVID-19)儿童的临床特点。方法回顾性分析53例无症状或亚临床感染的COVID-19患儿的临床资料,总结其流行病学史、临床分型、合并感染情况、鼻咽拭子新型冠状病毒(SARS-CoV-2)核酸转阴时间、实验室检查结果、住院天数及治疗转归。结果无症状或亚临床感染的COVID-19患儿占呼吸内科COVID-19病房住院患儿的30.5%(53/174),均呈家庭聚集性发病,其中无症状感染者35例(66%),亚临床感染者18例(34%)。17例(32%)患儿存在支原体感染。53例患儿鼻咽拭子SARS-CoV-2核酸转阴平均时间为9±4 d,实验室指标多在正常范围内,住院平均时间为11±4 d。18例亚临床感染患儿肺部CT表现为磨玻璃影、条索影、斑片状影,病变相对局限。结论呼吸内科COVID-19病房住院患儿中无症状或亚临床感染的COVID-19患儿所占比例较高,其传播风险应引起重视,提高有效防护是儿童防御的关键。Objective To study the clinical features of asymptomatic or subclinical coronavirus disease 2019(COVID-19)in children.Methods A retrospective analysis was performed for the clinical data of 53 children who were confirmed with asymptomatic or subclinical COVID-19,including epidemiological history,clinical typing,co-infection,time to clearance of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)nucleic acid in nasopharyngeal swabs,laboratory examination results,length of hospital stay,and treatment outcome.Results The children with asymptomatic or subclinical COVID-19 accounted for 30.5%(53/174)in children with COVID-19 hospitalized in the COVID-19 ward of Wuhan Children's Hospital.All cases occurred with familial aggregation.Among the 53 children,35(66%)had asymptomatic infection and 18(34%)had subclinical infection.Mycoplasma infection was found in 17 children(32%).For the 53 children,the mean time to clearance of SARS-CoV-2 nucleic acid in nasopharyngeal swabs was 9±4 days.Most laboratory markers were maintained within the normal range.The mean hospital stay was 11±4 days.Lung CT of 18 children with subclinical COVID-19 showed ground-glass opacities,linear opacities,and patchy opacities,with relatively limited lesions.Conclusions There is a high proportion of children with asymptomatic or subclinical COVID-19 among the children with COVID-19 hospitalized in the COVID-19 ward.The transmission risk of asymptomatic or subclinical COVID-19 should be taken seriously.

关 键 词：2019冠状病毒病 严重急性呼吸综合征冠状病毒2 无症状感染 亚临床感染 临床特征 儿童 

分 类 号：R725.6[医药卫生—儿科]