Comparative analysis of clinical features of SARS-CoV-2 and adenovirus infection among children
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RESEARCH
Comparative analysis of clinical features of SARS‑CoV‑2 and adenovirus infection among children Kuanrong Li1†, Ling Li1†, Xianfeng Wang2, Hui Li3, Jun Chen2, Lei Liu4, Jianbo Shao3, Yi Xu5, Liya He5,6, Sitang Gong5,6, Huimin Xia1,6 and Huiying Liang1*
Abstract Background: The new emerging coronavirus disease 2019 (COVID-19) overall shares similar symptoms with other common respiratory viral infections. We aimed in this study to compare COVID-19 and human adenovirus (HAdV) infections in pediatric patients regarding the frequencies of major clinical symptoms and the potential disparities in laboratory and imaging parameters. Methods: Following a case–control-like design, we built 72 age-matched pediatric COVID-19 and HAdV patient pairs. Their early symptoms and laboratory and imaging characteristics were then retrieved and compared. Results: Fever and cough were the most common symptoms for both infections but were seen more often in HAdV than in COVID-19 patients (92% vs. 66% and 60% vs. 18%, respectively). Compared with COVID-19 patients, children with HAdV infection had statistically significantly higher values of neutrophil count, neutrophil percentage, activated partial thromboplastin time, prothrombin time, lactate dehydrogenase, C-reactive protein, procalcitonin but lower values of lymphocyte percentage, total bilirubin, potassium and sodium. Thoracic computed tomography also revealed more anomalies in HAdV patients than in COVID-19 patients (95% vs. 67%). Conclusions: COVID-19 is an overall less symptomatic and less severe infection at admission compared to HAdV respiratory infection in pediatric population. Keywords: COVID-19, SARS-CoV-2, Adenoviruses, Respiratory infections, Children Background In late December 2019, a novel respiratory infectious disease caused by a new strain of coronavirus, namely severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), made its first appearance in Wuhan, China and spread rapidly around the world [1]. The disease was later on named coronavirus disease 2019 (COVID-19). As
*Correspondence: [email protected] † Kuanrong Li and Ling Li have contributed equally as co-first authors 1 Clinical Data Center, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Jinsui Road, Guangzhou 510623, Guangdong, China Full list of author information is available at the end of the article
of September 27, 2020, a total of 32,730,945 confirmed COVID-19 cases, including 991,224 deaths, have been reported globally [2]. Children appear to be less affected by COVID-19 and only account for 1–5% of diagnosed COVID-19 cases [3]. Fever and cough are the most commonly seen symptoms in children [4, 5]. Compared with adult COVID-19 patients, pediatric patients manifest relatively mild symptoms and rarely develop severe pneumonia [4, 5]. Human adenoviruses (HAdV) are a family of viruses causing 4–10% of respiratory illnesses in children and infants worldwide [6, 7]. Although COVID-19 and HAdV respiratory infection show similar symptoms such
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