无症状或亚临床感染的COVID-19儿童临床特征分析

doi:10.7499/j.issn.1008-8830.2004088

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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。

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	刘优靖
	陈鹏
	刘智胜
	李颖
	杜慧
	徐佳莉

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

Abstract：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.

Key words： COVID-19 Severe acute respiratory syndrome coronavirus 2 Asymptomatic infection Subclinical infection Clinical feature Child

收稿日期: 2020-04-13

通讯作者: 徐佳莉,女,主治医师。Email:7254608@qq.com。 E-mail: 7254608@qq.com

作者简介: 刘优靖,女,硕士,住院医师。

引用本文:

刘优靖,陈鹏,刘智胜等. 无症状或亚临床感染的COVID-19儿童临床特征分析[J]. 中国当代儿科杂志, 2020, 22(6): 578-582.

LIU You-Jing,CHEN Peng,LIU Zhi-Sheng et al. Clinical features of asymptomatic or subclinical COVID-19 in children[J]. CJCP, 2020, 22(6): 578-582.

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http://www.zgddek.com/CN/10.7499/j.issn.1008-8830.2004088 或 http://www.zgddek.com/CN/Y2020/V22/I6/578

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