Characterisation of COVID-19 Pandemic in Paediatric Age Group: A Systematic Review and Meta-Analysis.
- 作者列表："Mustafa NM","A Selim L
BACKGROUND:Coronavirus disease 2019 (COVID-19) is a pandemic first originated in Wuhan the capital of Hubei province, China in December 2019 and then spread globally. It is caused by SARS-CoV-2. Until 1st April 2020, the number of cases worldwide was recorded to be 823,626 with 40,598 deaths. Most of the reported cases were adults with few cases described in children and neonates. OBJECTIVES:We performed a systematic review and meta-analysis to analyse the disease characterisation in paediatric age group including the possibility of vertical transmission to the neonates. METHODS:Articles published up to 2nd April 2020 in PubMed and google Scholar were considered for this study. FINDINGS:The most frequently reported symptoms were cough 49% (95% CI: 42 - 55%) and fever 47% (95% CI: 41- 53%). Lymphopenia and increased Procalcitonin were recorded in (21%, 95% CI: 12 - 30%) and (28%, 95% CI: 18 - 37%) respectively. No sex difference for COVID-19 was found in paediatric age group (p = 0.7). Case fatality rate was 0%. Four out of 58 neonates (6.8%) born to COVID-19 confirmed mothers tested positive for the disease. CONCLUSION:The disease trajectory in Paediatric patients has good prognosis compared to adults. Intensive care unit and death are rare. Vertical transmission and virus shedding in breast milk are yet to be established.
研究背景: 冠状病毒病 2019 (新型冠状病毒肺炎) 是一种流行性疾病，于 2019 年 12 月首先起源于湖北省武汉市，随后在全球范围内传播。它是由SARS-CoV-2 引起的。直到 2020 年 4 月 1 日，全球病例数记录为 823,626 例，40,598 例死亡。大多数报告病例为成人，儿童和新生儿中描述的病例很少。 目的: 我们进行了系统综述和荟萃分析，以分析儿科年龄组的疾病特征，包括垂直传播给新生儿的可能性。 方法: 本研究考虑发表在PubMed和google Scholar中截至 2020 年 4 月 2 日的文章。 发现: 最常报告的症状是咳嗽 49% (95% CI: 42 - 55%) 发热 47% (95% CI: 41- 53%)。淋巴细胞减少和降钙素原升高分别为 (21%，95% CI: 12 - 30%) 和 (28%，95% CI: 18-37%)。儿科年龄组新型冠状病毒肺炎无性别差异 (p = 0.7)。病死率为 0%。在 58 名新生儿中，有 4 名 (6.8%) 是由新型冠状病毒肺炎确诊的母亲所生的。 结论: 与成人相比，儿科患者的疾病轨迹预后良好。重症监护病房和死亡是罕见的。母乳中的垂直传播和病毒脱落尚未确定。
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.
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.
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.