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COVID-19 in Children, Pregnancy and Neonates: A Review of Epidemiologic and Clinical Features.

儿童、妊娠和新生儿的新型冠状病毒肺炎: 流行病学和临床特征综述。

  • 影响因子:1.90
  • DOI:10.1097/INF.0000000000002700
  • 作者列表:"Zimmermann P","Curtis N
  • 发表时间:2020-06-01
Abstract

:The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has spread rapidly across the globe. In contrast to initial reports, recent studies suggest that children are just as likely as adults to become infected with the virus but have fewer symptoms and less severe disease. In this review, we summarize the epidemiologic and clinical features of children infected with SARS-CoV-2 reported in pediatric case series to date. We also summarize the perinatal outcomes of neonates born to women infected with SARS-CoV-2 in pregnancy. We found 11 case series including a total of 333 infants and children. Overall, 83% of the children had a positive contact history, mostly with family members. The incubation period varied between 2 and 25 days with a mean of 7 days. The virus could be isolated from nasopharyngeal secretions for up to 22 days and from stool for more than 30 days. Co-infections were reported in up to 79% of children (mainly mycoplasma and influenza). Up to 35% of children were asymptomatic. The most common symptoms were cough (48%; range 19%-100%), fever (42%; 11%-100%) and pharyngitis (30%; 11%-100%). Further symptoms were nasal congestion, rhinorrhea, tachypnoea, wheezing, diarrhea, vomiting, headache and fatigue. Laboratory test parameters were only minimally altered. Radiologic findings were unspecific and included unilateral or bilateral infiltrates with, in some cases, ground-glass opacities or consolidation with a surrounding halo sign. Children rarely needed admission to intensive care units (3%), and to date, only a small number of deaths have been reported in children globally. Nine case series and 2 case reports described outcomes of maternal SARS-CoV-2 infection during pregnancy in 65 women and 67 neonates. Two mothers (3%) were admitted to intensive care unit. Fetal distress was reported in 30% of pregnancies. Thirty-seven percent of women delivered preterm. Neonatal complications included respiratory distress or pneumonia (18%), disseminated intravascular coagulation (3%), asphyxia (2%) and 2 perinatal deaths. Four neonates (3 with pneumonia) have been reported to be SARS-CoV-2 positive despite strict infection control and prevention procedures during delivery and separation of mother and neonates, meaning vertical transmission could not be excluded.

摘要

: 新型新型冠状病毒 (SARS-CoV-2) 大流行已经在全球迅速蔓延。与最初的报告相反,最近的研究表明,儿童和成人一样可能感染病毒,但症状较少,疾病不太严重。在这篇综述中,我们总结了儿童感染SARS-CoV-2 的流行病学和临床特征。我们还总结了妊娠期感染SARS-CoV-2 的妇女所生新生儿的围产结局。我们发现了 11 个病例系列,共包括 333 名婴儿和儿童。总体而言,83% 的儿童有积极的接触史,主要是与家庭成员。潜伏期在 2 至 25 天之间变化,平均为 7 天。该病毒可从鼻咽分泌物中分离长达 22 天,从粪便中分离超过 30 天。高达 79% 的儿童报告合并感染 (主要是支原体和流感)。高达 35% 的儿童无症状。最常见的症状是咳嗽 (48%; 范围 19%-100%),发热 (42%; 11%-100%) 和咽炎 (30%; 11%-100%)。进一步的症状是鼻塞,流涕,心动过速,喘息,腹泻,呕吐,头痛乏力。实验室测试参数仅轻微改变。放射学表现无特异性,包括单侧或双侧浸润,在某些情况下,磨玻璃影或合并周围晕征。儿童很少需要入住重症监护病房 (3% ), 迄今为止,全球仅报告了少量儿童死亡。9 个病例系列和 2 个病例报告描述了 65 例妇女和 67 例新生儿在妊娠期发生SARS-CoV-2 感染的结局。2 例母亲 (3%) 入住重症监护病房。30% 的妊娠报告胎儿窘迫。37% 的妇女早产。新生儿并发症包括呼吸窘迫或肺炎 (18%) 、弥散性血管内凝血 (3%) 、窒息 (2%) 和 2 例围产儿死亡。4 例新生儿 (3 例肺炎) 尽管在分娩和母婴分离期间有严格的感染控制和预防程序,但仍报告为SARS-CoV-2 阳性,这意味着不能排除垂直传播。

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DOI:10.3346/jkms.2020.35.e79
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METHODS::Since mid-December of 2019, coronavirus disease 2019 (COVID-19) infection has been spreading from Wuhan, China. The confirmed COVID-19 patients in South Korea are those who came from or visited China. As secondary transmissions have occurred and the speed of transmission is accelerating, there are rising concerns about community infections. The 54-year old male is the third patient diagnosed with COVID-19 infection in Korea. He is a worker for a clothing business and had mild respiratory symptoms and intermittent fever in the beginning of hospitalization, and pneumonia symptoms on chest computerized tomography scan on day 6 of admission. This patient caused one case of secondary transmission and three cases of tertiary transmission. Hereby, we report the clinical findings of the index patient who was the first to cause tertiary transmission outside China. Interestingly, after lopinavir/ritonavir (Kaletra, AbbVie) was administered, β-coronavirus viral loads significantly decreased and no or little coronavirus titers were observed.

影响因子:4.36
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METHODS::In December 2019, a novel coronavirus (2019-nCoV) caused an outbreak in Wuhan, China, and soon spread to other parts of the world. It was believed that 2019-nCoV was transmitted through respiratory tract and then induced pneumonia, thus molecular diagnosis based on oral swabs was used for confirmation of this disease. Likewise, patient will be released upon two times of negative detection from oral swabs. However, many coronaviruses can also be transmitted through oral-fecal route by infecting intestines. Whether 2019-nCoV infected patients also carry virus in other organs like intestine need to be tested. We conducted investigation on patients in a local hospital who were infected with this virus. We found the presence of 2019-nCoV in anal swabs and blood as well, and more anal swab positives than oral swab positives in a later stage of infection, suggesting shedding and thereby transmitted through oral-fecal route. We also showed serology test can improve detection positive rate thus should be used in future epidemiology. Our report provides a cautionary warning that 2019-nCoV may be shed through multiple routes.

翻译标题与摘要 下载文献
影响因子:2.48
发表时间:2020-04-01
来源期刊:Infection
DOI:10.1007/s15010-020-01401-y
作者列表:["Cheng ZJ","Shan J"]

METHODS::There is a current worldwide outbreak of a new type of coronavirus (2019-nCoV), which originated from Wuhan in China and has now spread to 17 other countries. Governments are under increased pressure to stop the outbreak spiraling into a global health emergency. At this stage, preparedness, transparency, and sharing of information are crucial to risk assessments and beginning outbreak control activities. This information should include reports from outbreak sites and from laboratories supporting the investigation. This paper aggregates and consolidates the virology, epidemiology, clinical management strategies from both English and Chinese literature, official news channels, and other official government documents. In addition, by fitting the number of infections with a single-term exponential model, we report that the infection is spreading at an exponential rate, with a doubling period of 1.8 days.

呼吸道感染方向

呼吸道感染分为上呼吸道感染与下呼吸道感染。上呼吸道感染是指自鼻腔至喉部之间的急性炎症的总称,是最常见的感染性疾病。下呼吸道感染是最常见的感染性疾患,治疗时必须明确引起感染的病原体以选择有效的抗生素。

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