ABSTRACT
Objective:To evaluate the clinical significance of molecular detection testing multiple pathogens in children with viral central nervous system infections.Methods:We retrospectively included 176 children who were suspected with central nervous system infection at Shanghai Children′s Medical Center from January 2017 to May 2021.Film Array Meningitis/Encephalitis Panel(FA-M/E) was used to test cerebrospinal fluid samples of these children.The results were analyzed compared with clinical symptoms and cerebrospinal fluid indices.Results:There were 34 samples with positive FA-M/E virus detection(19.32%, 34/176). Among the 34 samples, enterovirus was the most common pathogen(27 cases, 79.41%). In different combinations, the sensitivity and positive predictive value were all less than 90%.The median time for antiviral drugs used in FA-M/E virus-positive and negative children was 4.5(0, 8.5)d and 2.6(0, 2.0)d, respectively.The difference was statistically significant( P<0.05). Conclusion:Molecular tests of multiple pathogens can quickly and sensitively detect pathogens.It can improve the efficacy of clinical diagnosis of viral central nervous system infection.
ABSTRACT
Objective:To investigate the clinical characteristics of SARS-CoV-2 Omicron variant BA.2.2 infection in children with different basic diseases.Methods:A total of 76 children with different basic diseases admitted to Shanghai Children′s Medical Center, Shanghai Jiao Tong University School of Medicine from March 2 to June 10, 2022 were retrospectively analyzed in terms of clinical manifestations, supplementary examination, treatment and prognosis.These children were divided into hematologic tumor group and non-hematologic tumor group which included cardiopulmonary disease group, neurological disease group and congenital malformation group.The clinical characteristics and prognosis of SARS-CoV-2 Omicron variant infection in children with basic diseases were analyzed.Results:Among 76 children with basic diseases, 61 patients were newly diagnosed with fever and 15 patients were asymptomatic.There were 26, 22, 20, and 8 cases with hematologic tumor diseases, cardiopulmonary diseases, neurological diseases and congenital malformation, respectively.The average fever time was 3-7 days.There was no significant difference in the clinical manifestations among each group ( P>0.05). However, children with hematological tumors were more prone to single organ or multiple organ dysfunction.The level of C-reactive protein was higher than that in the non-hematologic tumor group, while the white blood cell count, neutrophil count, lymphocyte count and hemoglobin were lower than those in the non-hematologic tumor group.The time of virus negative transformation and the duration of fever were higher than those in the non-hematologic tumor group, with statistical significance ( P<0.05). Among the children in the hematologic tumor group, the blood routine and inflammation indexes of children infected with SARS-CoV-2 after chemotherapy within 2 weeks were worse than those in the non-chemotherapy group, and the duration of fever and the time of virus negative transformation were significantly longer ( P<0.05). Three children with hematologic tumor showed virus positive recovery after chemotherapy and surgical treatment after virus negative transformation. Conclusion:Omicron variant BA.2.2 of SARS-CoV-2 has no serious impact on children with cardiopulmonary diseases, nervous system diseases and congenital malformations.However, the duration of fever and virus positive time in hematologic tumor group extended, especially after chemotherapy.It has an important impact on the formulation of epidemic prevention and timing selection of chemotherapy for children with hematological tumors.