婴幼儿2019冠状病毒病的临床特点及胸部CT表现

周昀, 杨根东, 冯凯, 黄华, 云永兴, 牟薪砚, 王立非

中国当代儿科杂志 ›› 2020, Vol. 22 ›› Issue (3) : 215-220.

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中国当代儿科杂志 ›› 2020, Vol. 22 ›› Issue (3) : 215-220. DOI: 10.7499/j.issn.1008-8830.2020.03.007
儿童新型冠状病毒感染专栏

婴幼儿2019冠状病毒病的临床特点及胸部CT表现

  • 周昀, 杨根东, 冯凯, 黄华, 云永兴, 牟薪砚, 王立非
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Clinical features and chest CT findings of coronavirus disease 2019 in infants and young children

  • ZHOU Yun, YANG Gen-Dong, FENG Kai, HUANG Hua, YUN Yong-Xing, MOU Xin-Yan, WANG Li-Fei
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摘要

目的 探讨婴幼儿2019冠状病毒病(COVID-19)的临床特点及胸部CT表现。方法 收集并回顾性分析2020年1月20日至2月10日经核酸检测确诊为COVID-19的婴幼儿(0~3岁)患者的临床资料及胸部CT资料。结果 9例患儿均有流行病学史,呈家庭聚集性发病。9例患儿中无症状5例,发热4例,咳嗽2例,流涕1例,均无呼吸系统以外症状。9例患儿实验室检查均未见白细胞及淋巴细胞计数减少,其中6例淋巴细胞计数升高及2例白细胞计数升高。9例患儿中8例CT显示肺部炎症,病灶均位于胸膜下或叶间裂下,3例病灶同时沿支气管血管束分布;病灶形态以结节状(6例)及小斑片状(7例)为主;6例病灶呈磨玻璃影及实变影共存,其中3例可见"晕征",未见典型"铺路石征"。结论 婴幼儿COVID-19患者临床症状轻,影像学表现不如成人典型,其诊断需结合流行病学史及核酸检测综合判断,胸部CT对于无症状患儿的早期诊断有指导意义。

Abstract

Objective To study the clinical features and chest CT findings of coronavirus disease 2019 (COVID-19) in infants and young children. Methods A retrospective analysis was performed for the clinical data and chest CT images of 9 children, aged 0 to 3 years, who were diagnosed with COVID-19 by nucleic acid detection between January 20 and February 10, 2020. Results All 9 children had an epidemiological history, and family clustering was observed for all infected children. Among the 9 children with COVID-19, 5 had no symptoms, 4 had fever, 2 had cough, and 1 had rhinorrhea. There were only symptoms of the respiratory system. Laboratory examination showed no reductions in leukocyte or lymphocyte count. Among the 9 children, 6 had an increase in lymphocyte count and 2 had an increase in leukocyte count. CT examination showed that among the 9 children, 8 had pulmonary inflammation located below the pleura or near the interlobar fissure and 3 had lesions distributed along the bronchovascular bundles. As for the morphology of the lesions, 6 had nodular lesions and 7 had patchy lesions; ground glass opacity with consolidation was observed in 6 children, among whom 3 had halo sign, and there was no typical paving stone sign. Conclusions Infants and young children with COVID-19 tend to have mild clinical symptoms and imaging findings not as typical as those of adults, and therefore, the diagnosis of COVID-19 should be made based on imaging findings along with epidemiological history and nucleic acid detection. Chest CT has guiding significance for the early diagnosis of asymptomatic children.

关键词

2019冠状病毒病 / 严重急性呼吸综合征冠状病毒2 / 胸部CT / 婴幼儿

Key words

Coronavirus disease 2019 / Severe acute respiratory syndrome coronavirus 2 / Chest CT / Infant and young child

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导出引用
周昀, 杨根东, 冯凯, 黄华, 云永兴, 牟薪砚, 王立非. 婴幼儿2019冠状病毒病的临床特点及胸部CT表现[J]. 中国当代儿科杂志. 2020, 22(3): 215-220 https://doi.org/10.7499/j.issn.1008-8830.2020.03.007
ZHOU Yun, YANG Gen-Dong, FENG Kai, HUANG Hua, YUN Yong-Xing, MOU Xin-Yan, WANG Li-Fei. Clinical features and chest CT findings of coronavirus disease 2019 in infants and young children[J]. Chinese Journal of Contemporary Pediatrics. 2020, 22(3): 215-220 https://doi.org/10.7499/j.issn.1008-8830.2020.03.007

参考文献

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