ABSTRACT
Objective:To investigate the clinical characteristics and serotyping characteristics of respiratory syncytial virus(RSV)infection in children prevalent during summer of 2020 in Shenzhen City, and provide basis for the diagnosis, monitoring and prevention of RSV infection in this area.Methods:The clinical data of 509 cases of RSV infection were analyzed in the Respiratory Department at Shenzhen Children′s Hospital from July 1, 2020 to August 31, 2020.The children diagnosed with pneumonia were divided into mild RSV pneumonia group and severe RSV pneumonia group according to the severity.The age, sex, clinical manifestations, basic diseases, mixed infection, clinical diagnosis of the patients were analyzed.Results:In 509 children with RSV infection, the male to female ratio was 1.84∶1, and the mean thermal range was (3.98±3.25) d. The detection rate of RSV was 51.4% (126/245) in children aged < 6 months, 45.6% (247/542) in children aged from 6 months to 2 years, 41.8% (123/294) in children aged from 2 to 5 years, and 8.5% (13/153) in children aged > 5 years.Common clinical manifestations were cough (96.2%), fever (72.5%), runny nose (61.9%), and nasal congestion (54.6%). Of the 509 cases, 123 (24.2%) had underlying diseases and 49 (9.6%) had mixed infections.A total of 371 cases had RSV pneumonia, including 280 mild cases (55.0%) and 91 severe cases (17.8%). Compared with the mild RSV pneumonia group, the severe RSV pneumonia group was significantly higher in male, age < 1 years, proportion of wheezing, underlying disease, mixed infection, and hospitalization time and fever time (all P<0.05). Multivariate analysis showed that age less than 1 year, mixed infection and underlying diseases were the high risk factors of severe RSV pneumonia( OR=10.1, 14.3 and 3.4, respectively, all P<0.05). Of the 198 serotyping cases, 18 were type A and 180 were type B. Conclusion:During the summer of 2020, the epidemic of RSV infection in children in Shenzhen is dominated by type B. In addition to children aged from 6 months to 2 years, children aged 2-5 years are also susceptible groups.Age<1 year, underlying diseases and mixed infection are independent risk factors of severe RSV pneumonia in children.
ABSTRACT
Clinical data of a case of occult pulmonary actinomycosis with foreign body admitted to Shenzhen Children′s Hospital were retrospectively analyzed, and the relevant literatures were retrieved and reviewed.A female patient aged 6 years and 9 months planned to receive hematopoietic stem cell transplantation due to thalassemia.During the plain chest CT examination before the transplantation, flakes of shadows were examined in the right lower lung.The child had no clinical symptoms or pulmonary signs.The granulation tissue hyperplasia of the right lower lobe was detected by tracheoscopy, which was harvested for examination under tracheoscopy, and actinomycete infection was confirmed.Several bone fragments were found wrapped inside the granulation.After 6 months of treatment with Amoxicillin and Clavulanate potassium, the tracheoscopic manifestations and chest CT were improved.Pulmonary actinomycosis is a rare pulmonary infectious disease, which is much rarer in children than adults, manifesting as an insidious onset and atypical clinical manifestations.However, foreign bodies in children′s airway are common, which is favorable to infection.In clinical detection of actinomycete infection, the cause of infection should be concerned to prevent misdiagnosis and mistreatment.
ABSTRACT
Objective:To investigate the etiological characteristics and changes of plastic bronchitis(PB)in children from 2010 to 2019 at Shenzhen Children′s Hospital, and provide reference basis for improving the understanding of PB etiology.Methods:The clinical data of children diagnosed with infectious-associated PB at Shenzhen Children′s Hospital from Jan 2010 to Dec 2019 were retrospectively analyzed, and the etiological characteristics and changes were summarized.Results:There were 94 cases of mycoplasma pneumoniae, 38 cases of influenza virus, 41 cases of adenovirus, 16 cases of mixed infection, 11 cases of bacteria, and 57 cases of unclear etiology in 266 infectious-associated PB children.The distribution of PB in each age group: 15 cases were infants, 63 cases were toddlers, 112 cases were preschoolers, and 76 cases were school-age children.Adenovirus was the main pathogen of PB in infants and toddlers(60.0%, 28.6%), and mycoplasma pneumoniae(34.8%, 60.5%) as well as influenza virus(13.4%, 22.4%) were the main pathogen in preschool and school-age children, with statistically significant difference( P<0.001). From 2010 to 2019, the annual positive rates of pathogens were 62.5%, 60.0%, 66.7%, 74.1%, 64.0%, 50.0%, 93.3%, 57.1%, 75.0%, and 84.7%, respectively.PB was caused by mycoplasma pneumoniae infection every year.From 2016 to 2019, PB caused by mycoplasma pneumoniae infection increased year by year, while PB caused by adenovirus infection increased every other year. Conclusion:Mycoplasma pneumoniae was the most common pathogen of PB, followed by adenoviruses and influenza viruses, while bacteria, fungi and other viruses were relatively rare.In the infant group, adenovirus infection was predominant, while in preschool and school-age children group, mycoplasma pneumoniae and influenza virus infection were predominant.
ABSTRACT
Objective:To analyze the characteristics of sleep disordered breathing (SDB) in children with allergic rhinitis (AR), and improve the diagnosis and treatment at AR combined with obstructive sleep apnea (OSA).Methods:The clinical data of 120 patients with AR and OSA (AR and OSA group) admitted to the respiratory department at Shenzhen Children′s Hospital from May 2019 to December 2020 were retrospectively analyzed.A total of 120 children diagnosed with OSA and excluded AR during the same period were selected as control group.The SDB day and night symptoms, sleep structure characteristics and sleep breathing events were compared between two groups.Results:The average course of disease in children with AR and OSA was significantly longer than that in control group ( P=0.030). The main manifestations of children in AR and OSA group were mouth breathing (100.0%), snoring (99.2%), nasal obstruction (88.5%), and restless sleep (68.0%). There was no significant difference in sleep structure between two groups ( P>0.05), but the sleep efficiency of AR and OSA group was significantly lower than that of control group ( P=0.028). The respiratory events apnea hypopnea index, obstructive apnea index, obstructive apnea hypopnea index, hypopnea index and oxygen desaturation index of each sleep period in AR and OSA group were significantly higher than those in control group ( P<0.05). Among the children in AR and OSA group, moderate and severe OSA were the main manifestations, and the difference between two groups was statistically significant ( P<0.001). Conclusion:The combination of AR delayed the course of OSA in children.The main characteristics of sleep disordered breathing in children with AR are mouth opening, restless sleep, snoring and nasal obstruction.The sleep efficiency is decreased.Obstructive hypopnea and apnea are the most common respiratory events, and oxygen deficiency often occurs in rapid eye movement phase.Children with AR are more likely to have moderate or severe obstructive sleep apnea.
ABSTRACT
Objective:To investigate the feasibility of nebulizing injectable Tobramycin for the treatment of Pseudomonas aeruginosa (Pa) in pediatric cystic fibrosis (CF) patients. Methods:The clinical data of 3 CF children with Pa infection who were treated by nebulizing injectable Tobramycin in Shenzhen Children′s Hospital from September 2017 to March 2021 were retrospectively analyzed.The efficacy and safety were explored.The nebulized injectable Tobramycin (160 mg/dose) was given twice daily after airway clearance.After one-month treatment course, oral Ciprofloxacin would be given [30 mg/(kg·d)] to patients for another 1 month if Pa was still positive in repeat sputum cultures.Results:There were 2 males and 1 female in 3 cases recruited.The youngest patient was 1-year-old when receiving Tobramycin treatment.After airway clearance and inhalation of injectable Tobramycin, all had improvements in respiratory symptoms and chest CT scan.Two cases took additional oral Ciprofloxacin as Pa was still positive after the 1-month treatment course of Tobramycin.Pa turned to negative in all 3 cases after treatment for 3 months to 1.5 years.Besides, after treatment all the 3 patients had normal liver and renal functions, and normal hearing in multiple follow ups.One patient had a normal brainstem auditory evoked potential in the reexamination.Conclusions:Nebulizing injectable Tobramycin would be a reasonable alternative to inhaled Tobramycin solution for treating pediatric CF patients with Pa in view of the present condition in mainland China.However, it is still worth further study and discussion.
ABSTRACT
The clinical data of a case diagnosed with MIRAGE syndrome in the Respiratory Department of Shenzhen Children′s Hospital in June 2020 were analyzed retrospectively.The 11-month-old boy was admitted to the hospital because of " intermittent fever for 1.5 months and blood oxygen decline for half a day" . Whole exome detection was carried out by using second-generation sequencing technology.The results showed spontaneous, heterozygous, missense variation in SAMD9 gene (NM_017654) and the mutation site was c. 2471G>A.Review of the literature found that all of the children (47 cases) were born prematurely and their parents were not intermarriage.Besides, they had overall growth retardation, and some suffered from myelodysplasia, recurrent infection, adrenal insufficiency, genital phenotypes and enteropathy.Among SAMD9 gene variation, mutations c. 1376G>A and c. 2471G>A are most frequent.Attention should be paid to the MIRAGE syndrome in children with premature birth and full development lag after birth.
ABSTRACT
Post-COVID-19 condition in children refers to the presence of physical symptoms or syndromes lasting more than 12 weeks after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, which can be manifested as a combination of various signs and symptoms.Girls, school-aged, adolescents, and children with severe illness in the acute phase of COVID-19, with underlying allergic diseases and poor baseline physical and mental health are high-risk factors for post-COVID-19 condition in children.Pathogenesis may be related to viral persistence, autoimmunity, chronic inflammatory responses, chronic inflammation of vascular endothelial cells, and microthrombosis.A comprehensive treatment scheme including symptoms relieving treatment, rehabilitation, and psychological support.This article reviews the epidemiology, clinical manifestations, pathogenesis, diagnosis, treatment, and management of the post-COVID-19 condition in children to improve clinicians′ comprehension of the disease.
ABSTRACT
The Streptococcus pneumoniae infection is still a leading cause of death and disability of children under 5 years old.To enhance the level of diagnosis and treatment in children′s pneumococcal diseases and contribute to the health of children in China, in April 2020, the Respiratory Group of Chinese Pediatric Society, Chinese Medical Association has developed an expert consensus for diagnosis, treatment and prevention of pneumococcal diseases in children.Now the consensus is interpreted as follows, including the burden of pneumococcal diseases, clinical characteristics, serotypes, drug resistance and vaccine precaution.
ABSTRACT
Objective:To summarize the characteristics of eosinophilia in peripheral blood in children with parasitic diseases.Methods:All clinical data of children with parasitic diseases who were diagnosed in Shenzhen Children′s Hospital from June 2002 to June 2020 were collected to analyze the characteristics of eosinophil changes in peripheral blood after parasitic infection.Results:(1)A total of 37 cases of parasitic diseases were diagnosed in children, with 25 males and 12 females, aged from 10 months to 12 years and 7 months, and the median age was 5 years and 3 months.(2)Among 37 cases, the absolute number of eosinophils in peripheral blood was increased in 32 cases (86.49%), with a range of (0.55-43.80)×10 9/L: 6 cases (18.75%) were slightly increased, 8 cases (25.00%) were moderately increased, and 18 cases (56.25%) were severely increased.(3)As for eosinophilia in peripheral blood of different insect species, there were 16 cases (50.00%) of fasciola infection, 4 cases (12.50%) of fasciola infection, 3 cases (9.38%) of mixed infection, 2 cases (6.25%) of schistosomiasis, plerocercoid, hydatid and cysticercosis infection, and 1 case (3.13%) of ascaris infection.The degrees of the increase of eosinophils in peripheral blood infected by different species of parasites were different ( Fisher′ s value 17.97, P=0.01), with statistically significant differences.(4)Eosinophilia in peripheral blood was involved in different systems, with respiratory system in 18 cases (48.65%), digestive system in 13 cases (35.14%), skin in 7 cases (18.92%), central nervous system in 5 cases(13.51%), circulatory system in 3 cases (8.11%), and others in 2 cases (5.41%). (5)There were 5 cases of parasitic infection without eosinophilia, including 2 cases of Blastocystis hominis, and 1 case of mixed infection with plerocercoid and cysticercosis, 1 case of cysticercosis and 1 case of trichinella spiralis.The increase of eosinophils in peri-pheral blood after different systems was different, without statistically significant differences ( Fisher′ s value 7.37, P=0.06). Conclusions:Eosinophil in peripheral blood is a common phenomenon of parasitic infection in children.The increased severity is related to parasite species, instead of the site of systemic involvement.
ABSTRACT
Since December 2019, the novel coronavirus (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) infection has broken out worldwide, causing enormous social and economic burdens.Sudden exacerbations in SARS-CoV-2 infected people may be caused by infection-related cytokine storms.The basic state of the body and the strength of the immune response determine the prognosis of SARS-CoV-2.The interaction between proinflammatory factors and anti-inflammatory factors, and continued proinflammatory response cause lung edema, exudation, progression to acute respiratory distress syndrome involving the lung tissues and organs, multi-organ failure, and even death.The efficacy of antiviral therapy alone for immune complications like cytokine storm during viral infection is not ideal, and the targeted therapy of cytokines has become a potentially popular therapeutic strategy.Early identification and appropriate treatment of immune complications contribute to reduce the morbidity and mortality of severe viral infections.
ABSTRACT
Objective:To investigate the etiology, clinical characteristics and outcome of severe pneumonia-associated hemophagocytic lymphohistiocytosis, and to analyze the risk factors for mortality.Methods:Clinical data of patients with severe pneumonia-associated hemophagocytic lymphohistiocytosis admitted to Shenzhen Children′s Hospital from February 2009 to February 2019 were retrospectively analyzed.The data included clinical characteristics, etiology, clinical manifestations, laboratory data, treatment and outcomes of the patients.The clinical characteristics and laboratory data of the survival group and the death group were compared by independent sample t-test. Results:(1) Clinical characteristics: the patients were aged from 3 months to 8 years and 7 months, including 15 males and 15 females.Severe pneumonia-associated hemophagocytic lymphohistiocytosis accounted for 2.74% (30/1 096 cases) of severe pneumonia in the same period.(2) Etiology: Mycoplasma pneumoniae infection was found in 8 cases (8/30 cases, 26.67%), virus infection in 7 cases (7/30 cases, 23.33%, including 5 cases with adenovirus infection, 1 case with EB virus infection, and 1 case with cytomegalovirus infection), Mycoplasma pneumoniae complicated with adenovirus infection in 4 cases (4/30 cases, 13.33%), bacterial infection in 3 cases (3/30 cases, 10%), and fungal infection in 2 cases, Mycobacterium tuberculosis infection in 1 case.The pathogens were not identified in 5 patients.(3) Clinical manifestations: fever and hepatomegaly were present in all patients.Besides, 86.67% (26/30)patients had fever duration more than 10 days, 83.33% (25/30 cases) patients had cough, 76.66% (23/30 cases) patients had splenomegaly, and 33.33% (10/30 cases) patients had nervous system symptoms.Laboratory data showed varying degrees of reduction of binary and ternary systems in 80.00%(24/30 cases) of the patients.Liver function impairment was found in half of the patients, and serum ferritin and lactate dehydrogenase levels were elevated in all patients.(4) The mortality rate was 30.00% (9/30 cases). The differences in age, hypertriglyceridemia and high serum ferritin levels between the survival and death groups were significant (all P<0.05). Conclusions:Severe pneumonia-associated hemophagocytic lymphohistiocytosis is a disease with a high mortality rate.Patients with Mycoplasma pneumoniae and adenovirus pneumonia are more likely to suffer from secondary hemophagocytic lymphohistiocytosis.Younger age, hypertriglyceridemia and high serum ferritin levels are indicative of poor prognosis.
ABSTRACT
Objective@#To summarize the clinical features of immunodeficiency diseases with interstitial lung disease (ILD) as major clinical manifestations and to improve understanding etiology of ILD.@*Methods@#The clinical features and clinical clues for diagnosis of six cases with immunodeficiency presented with ILD in Shenzhen Children′s Hospital from January 2014 to December 2016 were retrospectively analyzed.@*Results@#The patients′ age ranged from 3 months to 5 years and 9 months, 5 cases were male. All cases had cough and tachypnea, 3 cases had lung infection and respiratory failure, 2 cases had chronic hypoxia and one had clubbing. Three cases had skin rashes; 5 cases had failure to thrive. Chest CT scan showed diffuse ground glass opacity in all the 6 cases, and 2 cases had cystic changes and one had "crazy-paving" pattern. Five patients were suspected to have surfactant dysfunction and genetic testing was performed before diagnosis of immunodeficiency, of which the results were negative. With human immunodeficiency virus antibody test or immunologic laboratory testing and/or immune genetic panel, acquired immune deficiency syndrome was confirmed in one case, hyper-IgM syndrome was confirmed in two cases and hyper-IgE syndrome in one case, Wiskott-Aldrich syndrome in one and STAT3 gain of function genetic mutation in another. All cases had clinical clues indicative of underlying immunocompromise.@*Conclusions@#The clinical features of immunodeficiency diseases with ILD are cough, tachypnea or hypoxia, respiratory failure with infection, diffuse ground glass opacity in Chest CT imaging. With thorough medical history and immunology screening, there would be clinical clues indicative of underlying immunocompromise. Screening for immunodeficiency disease should be emphasized in the differential diagnosis of ILD, otherwise it may lead to misdiagnosis or unnecessary testing.
ABSTRACT
Objective:To evaluate the enrollment rate, mutation rate and causes of variability the clinical pathway of bronchopneumonia.Methods:The enrollment rate, completion rate, variation and reasons of the clinical pathway in Beijing Children′s Hospital, Capital Medical University from January 2012 to December 2016 were retrospectively collected.Data of patients after the clinical pathway of bronchopneumonia in other tertiary class A hospitals were gathered by questionnaires, and the enrollment rate, completion rate, variation rate and reasons were analyzed.Results:(1)At the end of 2016, 11 of the 13 hospitals included in this study had implemented the clinical pathway for 5 years, 1 hospital for 3 years, and 1 hospital for 2 years.(2) Eleven hospitals provided their enrollment rates.The enrollement rate of 2 hospitals was<50%, and that of 9 hospitals was>80%.The annual completion rate of Beijing Children′s Hospital was ≥75%, and the completion rates offered by 8 hospitals were basically >70%.(3) Since the implementation of the clinical pathway for 5 years in Beijing Children′s Hospital, a total of 427 cases were enrolled of which 93 cases were mutated (variability 21.78%). The variability of 5 hospitals was maintained at <15%.The variability of 3 hospitals decreased with the implementation years, and became qualified.The variability of 1 hospital first rebounded and then controlled; 1 hospital increased by 27.65%; 1 hospital was first controlled and rebounded; 1 hospital was always >15%.The main cause of the mutation was coexisting diseases, complications, progression of the disease, or correction of the first diagnosis, etc.Conclusions:The completion rate of tertiary class A hospitals meets the requirements of national policy.However, the enrollment rate needs to be improved, and the variation rate among different hospitals differs a lot.Further implementation of the clinical pathway should be strengthened and monitored.
ABSTRACT
Multisystem inflammatory syndrome in children (MIS-C) reported in the United States and European countries is a disease with multi-organ involved symptoms related with 2019 Novel Coronavirus infection, which has never been reported in China.Although its symptoms are similar to Kawasaki disease, MIS-C has characteristics of higher frequency in older children and adolescents, gastrointestinal symptoms, haemodynamic instability, myocarditis and elevated inflammatory markers.Most of the children need intensive care.The pathogenesis and long-term prognosis of the disease need further study.
ABSTRACT
Objective:To investigate the clinical characteristics, drug resistance and serotypes of children′s invasive pneumococcal disease(IPD) in Shenzhen.Methods:Clinical data and drug sensitivity results of IPD children enrolled in Shenzhen Children′s Hospital, from January 2012 to December 2018, were analyzed retrospectively, and serotypes of the retained strains were identified by capsule swelling method or polymerase chain reaction(PCR) method.Results:One hundred and forty-one cases were enrolled, majority of them were less than 2 years old (86 cases, 61.0%). A total of 99 cases(70.2%) had onset in autumn and winter.The clinical manifestation included single bloodstream infection(62 cases, 45.4%), purulent meningitis(30 cases, 21.3%), pneumonia with bacteremia(28 cases, 19.9%), bone and joint infection(12 cases, 8.5%), purulent pleurisy (4 cases, 2.8%), peritonitis (3 cases, 2.1%), and infective endocarditis (2 cases, 1.4%). Underlying diseases were found in 33 cases(23.4%), co-infection in 14 cases (9.9%), complications in 39 cases (27.7%). After active treatment, 5 cases (3.5%) who were all under 2 years old died, and all of the isolates had multi-drug resistance.Four cases (2.8%) were discharged without recovery, and the rest cases were improved.The incidence of Penicillin insensitive Streptococcus pneumoniae (PNSP) with underlying diseases (30.7% vs.15.4%, χ2=3.956), meningitis(32.0% vs.9.2%, χ2=10.722) and multiple drug resistance (86.7% vs.63.1%, χ2=10.538)were higher than those of Penicillin sensitive Streptococcus pneumo- niae(PSSP)(all P<0.05). The serotypes of 97 invasive Streptococcus pneumoniae strains were identified.Types of 14 and 19F (21 strains for each type, 21.6%) were the most common, followed by type 19A (15 strains, 15.5%), type 6B and 23F (13 strains for each type, 13.4%), and type 3 (3 strains, 3.1%). The serotype coverage of 13-valent pneumococcal conjugate vaccine (PCV13) was 92.8% (90/97 strains). Conclusions:Children under 2 years old are prone to IPD and death.The IPD distribution varies in different seasons, and single bloodstream infection is the most common clinical manifestation; PNSP is more likely to occur in children with underlying diseases and meningitis, and the multi-drug resistance of pathogenic strains may be related to poor prognosis.PCV13 can cover most IPD serotypes.
ABSTRACT
Objective:To explore the clinical characteristics and appropriate treatment of occult pneumococcal bacteremia (OPB) in children.Methods:The clinical characteristics, drug sensitivity and antibiotic use of 39 children with OPB who met the inclusion criteria in the Pediatric Internal Medicine Ward of Shenzhen Children′s Hospital from January 2013 to December 2018 were retrospectively analyzed.Results:The median age of onset in OPB in children was 2 years and 4 months, and 74.4% of children(29/39 cases) were between 6 months and 3 years.The average total fever duration was 3.69 days (1-14 days), and the average hospital stay was 6.74 days.Peripheral blood white blood cell count was >15×10 9/L in 89.7% (35/39 cases) of the children, C-reactive protein was increased in 76.9% (30/39 cases) of the children, and procalcitonin > 2 mg/L in 38.9% (14/36 cases) of the children.During hospita-lization, all the children received the treatment of intravenous antibiotics.The antibiotics used initially included Cefuroxime in 11 cases (28.2%), Amoxicillin sulbactam sodium in 10 cases (25.6%), Ceftriaxone sodium in 7 cases (17.9%) and Meloxicillin sulbactam in 6 cases (15.4%). The average fever clearance time after the antibiotic therapy was 1.4 days, and the average intravenous antibiotics treatment time was 6.2 days.The results indicated that the insensitivity rate of Penicillin was 46.2%, the insensitivity rate of Amoxicillin, Ceftriaxone and Cefotaxime were 22.2%, 10.3% and 17.9%, respectively, Erythromycin resistant rate was 100.0%, and no patient was resistant to Vancomycin and Linezolid. Conclusions:OPB occurs most frequently in infants aged from 6 months to 3 years old, with low drug resistance to Amoxicillin, Ceftriaxone and Cefotaxime.Children with complete immunity have shorter fever duration and good prognosis after antibiotic treatment.
ABSTRACT
Streptococcus pneumoniae is the leading pathogen of community-acquired pneumoniae, acute otitis media and bacterial meningitis in children.The invasive pneumococcal diseases(IPDs) are also the main cause of death in children under 5 years old.Therefore, it′s an important task to prevent and control pneumococcal diseases in children worldwide, especially in developing countries.The inoculation of 13-valent pneumococcal conjugate vaccine(PCV13) is a chief precaution against IPDs in children, but PCV13 hasn′t been included in the immunization schedule in China.In this study, the research on the epidemiological characteristics of pneumococcal infections and pneumococcal diseases in children in China was reviewed with the view of providing strategic information for the control and prevention of pneumococcal diseases in children.
ABSTRACT
Influenza is an acute respiratory infectious disease caused by influenza virus, which can promote the adhesion and colonization of Streptococcus pneumoniae in respiratory epithelial cells, increasing the incidence of pneumococcal infections.Therefore, children should take early precautions against pneumococcal diseases during or before the influenza season.The progress in research on the epidemiology of influenza and the prevention of pneumococcal diseases in children was reviewed in this paper.
ABSTRACT
Objective@#To describe the characteristics of clinical manifestations and epidemiology of children with 2019 novel coronavirus (2019-nCoV) infection.@*Methods@#All 34 children with laboratory-confirmed 2019-nCoV infection by quantitative real-time reverse transcription-PCR through nasopharyngeal swab specimens were admitted to the Third People’s Hospital of Shenzhen from January 19 to Febuary 7, 2020. Clinical data and epidemiological history of these patients were retrospectively collected and analyzed.@*Results@#Among the 34 cases, 14 were males, and 20 were females. The median age was 8 years and 11 months. No patients had underlying diseases. There were 28 children (82%) related with a family cluster outbreak. There were 26 children (76%) with a travel or residence history in Hubei Province. These patients could be categorized into different clinical types, including 22 (65%) common cases, 9 (26%) mild cases and 3 (8.8%) asymptomatic cases. No severe or critical cases were identified. The most common symptoms were fever (17 cases, 50%) and cough (13 cases, 38% ). In the 34 cases, the white blood cell counts of 28 cases (82%) were normal. Five cases had white blood cell counts more than 10×109/L. One case had white blood cell counts less than 4×109/L. Neutropenia and lymphopenia was found in one case, respectively. C-reactive protein levels and erythrocyte sedimentation rates were elevated in 1 and 5 case, respectively. Elevated procalcitonin was found in 1 case and D-Dimer in 3 cases. The levels of lactic dehydrogenase (LDH) were more than 400 U/L in 10 cases. The CT images of these patients showed bilateral multiple patchy or nodular ground-glass opacities and/or infiltrating shadows in middle and outer zone of the lung or under the pleura. Twenty patients were treated with lopinavir and ritonavir. Glucocorticoids and immunoglobulin were not used in any cases. All the cases improved and were discharged from hospital. Further following up was need.@*Conclusions@#The clinical manifestations in children with 2019-nCoV infection are non-specific and are milder than that in adults. Chest CT scanning is heplful for early diagnosis. Children's infection is mainly caused by family cluster outbreak and imported cases. Family daily prevention is the main way to prevent 2019-nCoV infection.
ABSTRACT
The exhaled air of healthy people contains nitric oxide.Under the physiological condition, nasal nitric oxide(NNO) comes primarily from the sinuses, a little is produced in the nasal mucosa.Fractional exhaled nitric oxide is mainly from the trachea and bronchus.When airway diseases occur, it can influence the concentration of exhaled nitric oxide.Therefore, with the continuous improvement of technology in recent years, the measurement of NNO has been widely used in upper airway diseases of children.It is characteristics of quantitative, non-invasive, simple and safe.This article reviews the measurement methods of NNO and its clinical application in children upper airway diseases such as rhinitis, sinusitis, nasal polyps and adenoid hypertrophy.