Clinical manifestations and pathogen characteristics in children admitted for suspected COVID-19
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RESEARCH ARTICLE
Clinical manifestations and pathogen characteristics in children admitted for suspected COVID-19 Xiaofang Cai1, Hanlan Jiang1, Simin Zhang1, Shengying Xia1, Wenhui Du1, Yaoling Ma1, Tao Yu2, Wenbin Li (
✉)3
1
Department of Emergency, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430016, China; 2Department of Clinical Laboratory, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430016, China; 3Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
© Higher Education Press 2020
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; pediatrics; emergency; retrospective investigation; severe acute respiratory syndrome coronavirus 2
Introduction Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread around the world, constituting a public health emergency of international concern [1]. SARS-CoV-2 is the seventh coronavirus that has been identified to date that is known to cause human disease. Compared with SARS and Middle East respiratory syndrome (MERS) viruses that were responsible for pandemics in 2003 and 2012, respectively, SARS-CoV-2 is associated with a lower mortality rate but a higher transmission speed [2–5]. Most people, including children, are susceptible to SARS-CoV-2.
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