tetano
Editor, Senior Moderator
Front Med
. 2020 Oct 27.
doi: 10.1007/s11684-020-0820-7. Online ahead of print.
Clinical manifestations and pathogen characteristics in children admitted for suspected COVID-19
Xiaofang Cai[SUP] 1 [/SUP], Hanlan Jiang[SUP] 1 [/SUP], Simin Zhang[SUP] 1 [/SUP], Shengying Xia[SUP] 1 [/SUP], Wenhui Du[SUP] 1 [/SUP], Yaoling Ma[SUP] 1 [/SUP], Tao Yu[SUP] 2 [/SUP], Wenbin Li[SUP] 3 [/SUP]
Affiliations
Abstract
Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has spread around the world. However, approaches to distinguish COVID-19 from pneumonia caused by other pathogens have not yet been reported. We retrospectively analyzed the clinical data of 97 children with probable COVID-19. A total of 13 (13.4%) patients were confirmed positive for SARS-CoV-2 infection by nucleic acid RT-PCR testing, and 41 (42.3%) patients were found to be infected with other pathogens. Notably, no pathogen was detected in 43 (44.3%) patients. Among all patients, 25 (25.8%) had familial cluster exposure history, and 52 (53.6%) had one or more coexisting conditions. Fifteen (15.5%) patients were admitted or transferred to the PICU. In the 11 confirmed COVID-19 cases, 5 (45.5%) and 7 (63.6%) were positive for IgM and IgG against SARS-CoV-2, respectively. In 22 patients with suspected COVID-19, 1 (4.5%) was positive for IgG but negative for IgM. The most frequently detected pathogen was Mycoplasma pneumonia (29, 29.9%). One patient with confirmed COVID-19 died. Our results strongly indicated that the detection of asymptomatic COVID-19 or coexisting conditions must be strengthened in pediatric patients. These cases may be difficult to diagnose as COVID-19 unless etiologic analysis is conducted. A serologic test can be a useful adjunctive diagnostic tool in cases where SARS-CoV-2 infection is highly suspected but the nucleic acid test is negative.
Keywords: coronavirus disease 2019; emergency; pediatrics; retrospective investigation; severe acute respiratory syndrome coronavirus 2.
. 2020 Oct 27.
doi: 10.1007/s11684-020-0820-7. Online ahead of print.
Clinical manifestations and pathogen characteristics in children admitted for suspected COVID-19
Xiaofang Cai[SUP] 1 [/SUP], Hanlan Jiang[SUP] 1 [/SUP], Simin Zhang[SUP] 1 [/SUP], Shengying Xia[SUP] 1 [/SUP], Wenhui Du[SUP] 1 [/SUP], Yaoling Ma[SUP] 1 [/SUP], Tao Yu[SUP] 2 [/SUP], Wenbin Li[SUP] 3 [/SUP]
Affiliations
- PMID: 33106939
- DOI: 10.1007/s11684-020-0820-7
Abstract
Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has spread around the world. However, approaches to distinguish COVID-19 from pneumonia caused by other pathogens have not yet been reported. We retrospectively analyzed the clinical data of 97 children with probable COVID-19. A total of 13 (13.4%) patients were confirmed positive for SARS-CoV-2 infection by nucleic acid RT-PCR testing, and 41 (42.3%) patients were found to be infected with other pathogens. Notably, no pathogen was detected in 43 (44.3%) patients. Among all patients, 25 (25.8%) had familial cluster exposure history, and 52 (53.6%) had one or more coexisting conditions. Fifteen (15.5%) patients were admitted or transferred to the PICU. In the 11 confirmed COVID-19 cases, 5 (45.5%) and 7 (63.6%) were positive for IgM and IgG against SARS-CoV-2, respectively. In 22 patients with suspected COVID-19, 1 (4.5%) was positive for IgG but negative for IgM. The most frequently detected pathogen was Mycoplasma pneumonia (29, 29.9%). One patient with confirmed COVID-19 died. Our results strongly indicated that the detection of asymptomatic COVID-19 or coexisting conditions must be strengthened in pediatric patients. These cases may be difficult to diagnose as COVID-19 unless etiologic analysis is conducted. A serologic test can be a useful adjunctive diagnostic tool in cases where SARS-CoV-2 infection is highly suspected but the nucleic acid test is negative.
Keywords: coronavirus disease 2019; emergency; pediatrics; retrospective investigation; severe acute respiratory syndrome coronavirus 2.