D Wang1, X L Ju2, F Xie3, Y Lu4, F Y Li5, H H Huang6, X L Fang7, Y J Li8, J Y Wang9, B Yi10, J X Yue11, J Wang12, L X Wang13, B Li14, Y Wang15, B P Qiu16, Z Y Zhou17, K L Li18, J H Sun19, X G Liu20, G D Li21, Y J Wang10, A H Cao2, Y N Chen1. 1. Department of Pediatric Internal Medicine, Xi'an Children's Hospital, Xi'an 710003, China. 2. Department of Pediatrics, Qilu Hospital of Shandong University, Jinan 250012, China. 3. Pediatric Intensive Care Unit, General Hospital of Ningxia University, Yinchuan 750004, China. 4. Department of Pediatrics, the Fourth People's Hospital of Ningxia Hui Autonomous Region, Yinchuan 750021, China. 5. Department of Intensive Care Unit, Xi'an Number Eighth Hospital, Xi'an 710061, China. 6. Department of Infectious Diseases, Ankang Central Hospital, Ankang 725000, China. 7. Department of Pediatrics, Tongchuan Mining Bureau Central Hospital, Tongchuan 727000, China. 8. Department of Respiratory Medicine, Yan'an Second People's Hospital Affiliated to Yan'an University, Yan'an 716000, China. 9. Department of Infectious Diseases, Lanzhou Pulmonology Hospital, Lanzhou 730046, China. 10. Department of Pediatrics, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou 730050, China. 11. Department of Pediatrics,Xianyang Central Hospital, Xianyang 712000, China. 12. Department of Respiratory Medicine, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou 450018, China. 13. Pediatric Critical Care Medicine, Zhumadian Central Hospital, Zhumadian 463000, China. 14. Department of Pediatrics, Shijiazhuang Fifth Hospital, Shijiazhuang 050024, China. 15. Department of Neonatal Intensive Care Unit, the Affiliated Children's Hospital of Xi'an Jiaotong University, Xi'an 710003, China. 16. Department of Pediatrics, Tengzhou Central People's Hospital, Tengzhou 277500, China. 17. Department of Pediatrics, Heze Municipal Hospital, Heze 274000, China. 18. Department of Pediatrics, People's Hospital of Rizhao, Rizhao 276800, China. 19. Department of Infectious Diseases, Yantai Laiyang Central Hospital, Yantai 264000, China. 20. Department of Pediatrics, Weihai Municipal Hospital, Weihai 264200, China. 21. Department of Infectious Diseases, People's Hospital of Pingliang City, Pingliang 744000, China.
Abstract
Objective: To analyze the epidemiological history, clinical manifestations, treatment and the short-term prognosis of 31 cases of 2019 novel coronavirus (2019-nCoV) infection in children from six provinces (autonomous region) in northern China. Methods: A retrospective analysis of the epidemiological history, clinical symptoms, signs, laboratory examinations, chest imaging, treatment and the short-term prognosis of 31 cases of 2019-nCoV was conducted. The patients were diagnosed between January 25th, 2020 and February 21st, 2020 in 21 hospitals in 17 cities of six provinces (autonomous region) of Shaanxi, Gansu, Ningxia, Hebei, Henan and Shandong. Results: The age of the 31 children with 2019-nCoV infection was 7 years and 1 month (6 months-17 years). Nine cases (29%) were imported cases. Other 21 cases (68%) had contact with confirmed infected adults. One case (3%) had contact with asymptomatic returnees from Wuhan. Among the 31 children, 28 patients (90%) were family cluster cases. The clinical types were asymptomatic type in 4 cases (13%), mild type in 13 cases (42%), and common type in 14 cases (45%). No severe or critical type existed. The most common symptom was fever (n=20, 65%), including 1 case of high fever, 9 cases of moderate fever, 10 cases of low fever. Fever lasted from 1 day to 9 days. The fever of fifteen cases lasted for ≤3 d, while in other 5 cases lasted >3 d. Other symptoms included cough (n=14, 45%), fatigue (n=3, 10%) and diarrhea (n=3, 10%). Pharyngalgia, runny nose, dizziness, headache and vomiting were rare. In the early stage, the total leukocytes count in peripheral blood decreased in 2 cases (6%), the lymphocytes count decreased in 2 cases (6%), and the platelet count increased in 2 cases (6%).Elevation of C-reactive protein (10%, 3/30), erythrocyte sedimentation rate (19%, 4/21), procalcitonin (4%,1/28), liver enzyme (22%, 6/27) and muscle enzyme (15%, 4/27) occurred in different proportions. Renal function and blood glucose were normal. There were abnormal chest CT changes in 14 cases, including 9 cases with patchy ground glass opacities and nodules, mostly located in the lower lobe of both lungs near the pleural area. After receiving supportive treatment, the viral nucleic acid turned negative in 25 cases within 7-23 days. Among them, 24 children (77%) recovered and were discharged from hospital. No death occurred. Conclusions: In this case series, 2019-nCoV infection in children from six provinces (autonomous region) in northern China are mainly caused by close family contact. Clinical types are asymptomatic, mild and common types. Clinical manifestations and laboratory examination results are nonspecific. Close contact history of epidemiology, nucleic acid detection and chest imaging are important bases for diagnosis of 2019-nCoV infection. After general treatment, the short-term prognosis is good.
Objective: To analyze the epidemiological history, clinical manifestations, treatment and the short-term prognosis of 31 cases of 2019 novel coronavirus (2019-nCoV) infection in children from six provinces (autonomous region) in northern China. Methods: A retrospective analysis of the epidemiological history, clinical symptoms, signs, laboratory examinations, chest imaging, treatment and the short-term prognosis of 31 cases of 2019-nCoV was conducted. The patients were diagnosed between January 25th, 2020 and February 21st, 2020 in 21 hospitals in 17 cities of six provinces (autonomous region) of Shaanxi, Gansu, Ningxia, Hebei, Henan and Shandong. Results: The age of the 31 children with 2019-nCoV infection was 7 years and 1 month (6 months-17 years). Nine cases (29%) were imported cases. Other 21 cases (68%) had contact with confirmed infected adults. One case (3%) had contact with asymptomatic returnees from Wuhan. Among the 31 children, 28 patients (90%) were family cluster cases. The clinical types were asymptomatic type in 4 cases (13%), mild type in 13 cases (42%), and common type in 14 cases (45%). No severe or critical type existed. The most common symptom was fever (n=20, 65%), including 1 case of high fever, 9 cases of moderate fever, 10 cases of low fever. Fever lasted from 1 day to 9 days. The fever of fifteen cases lasted for ≤3 d, while in other 5 cases lasted >3 d. Other symptoms included cough (n=14, 45%), fatigue (n=3, 10%) and diarrhea (n=3, 10%). Pharyngalgia, runny nose, dizziness, headache and vomiting were rare. In the early stage, the total leukocytes count in peripheral blood decreased in 2 cases (6%), the lymphocytes count decreased in 2 cases (6%), and the platelet count increased in 2 cases (6%).Elevation of C-reactive protein (10%, 3/30), erythrocyte sedimentation rate (19%, 4/21), procalcitonin (4%,1/28), liver enzyme (22%, 6/27) and muscle enzyme (15%, 4/27) occurred in different proportions. Renal function and blood glucose were normal. There were abnormal chest CT changes in 14 cases, including 9 cases with patchy ground glass opacities and nodules, mostly located in the lower lobe of both lungs near the pleural area. After receiving supportive treatment, the viral nucleic acid turned negative in 25 cases within 7-23 days. Among them, 24 children (77%) recovered and were discharged from hospital. No death occurred. Conclusions: In this case series, 2019-nCoV infection in children from six provinces (autonomous region) in northern China are mainly caused by close family contact. Clinical types are asymptomatic, mild and common types. Clinical manifestations and laboratory examination results are nonspecific. Close contact history of epidemiology, nucleic acid detection and chest imaging are important bases for diagnosis of 2019-nCoV infection. After general treatment, the short-term prognosis is good.
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