ABSTRACT
Acute respiratory disease caused by 2019 novel coronavirus (2019-nCoV) has rapidly spread throughout China. Children and adults show a different clinical course. The purpose of the current study is to comparatively analyze the clinical characteristics of 2019-nCoV infection in children and adults and to explore the possible causes for the discrepancies present. The medical records of 25 adults and 7 children confirmed cases of 2019-2019-nCoV acute respiratory diseases were reviewed retrospectively. All children were family clusters. The total adult patients were differentiated into the local residents of Wuhan, a history of travel to Wuhan and direct contact with people from Wuhan. The numbers were 14 (56%), 10 (40%), and 1 (4%), respectively. The median incubation period of children and adults was 5 days (ranged, 3-12 days) and 4 days (ranged, 2-12 days), respectively. Diarrhoea and/or vomiting (57.1%) were demic by World Health Organiza more common in children, whereas for adults it was myalgia or fatigue (52%). On admission, the percentage of children having pneumonia (5%, 71.4%) was roughly the same as adults (20%, 80%). A total of 20% of adults had leucopoenia, but leukocytosis was more frequently in children (28.6%, P=.014). A higher number of children had elevated creatine kinase isoenzyme (57.1% vs 4%, P=.004). Antiviral therapy was given to all adult patients but to none of the children. In summary, knowledge of these differences between children and adults will not only be helpful for the clinical diagnosis of 2019-nCoV disease, but also for a future discussion on age-specific coronavirus infection.
Subject(s)
COVID-19/diagnosis , COVID-19/virology , SARS-CoV-2/physiology , Adolescent , Adult , COVID-19/epidemiology , COVID-19/therapy , Child , Child, Preschool , Clinical Decision-Making , Comorbidity , Disease Management , Environmental Exposure , Female , Humans , Infant , Male , Risk Factors , Symptom Assessment , Young AdultABSTRACT
OBJECTIVE: To investigate the value of urinary S100B protein and lactate/creatinine ratio determination in early identification of neonatal hypoxic-ischemic encephalopathy (HIE). METHODS: The levels of urinary S100B protein and urinary lactate/creatinine ratio were detected in 58 full-term newborn infants with HIE on the first, second and third day after birth. The severity of clinical manifestations, including the degree of encephalopathy, was assessed within 7 days after birth. Twenty five normal neonates were enrolled into the control groups. RESULTS: (1) The urinary S100B level of HIE neonates was significantly higher in samples collected throughout the monitoring period than those of the normal control groups (all P < 0.001). The urinary lactate/creatinine ratio of the HIE neonates was also significantly higher than that of normal control groups within the first day (P < 0.001). (2) A significantly positive correlation was found between the level of urinary S100B protein within three days and the urinary lactate/creatinine ratio within the first day and between the level of urinary S100B protein within three days and clinical degree (P < 0.05). (3) When S100B concentration was 0.47 microg/L and urinary lactate/creatinine ratio was 0.55, the sensitivity and specificity of detecting the third day urinary S100B alone, were respectively 90.4%, 91.9%. Detecting it associated with the first day urinary lactate/creatinine ratio could increase the sensitivity and specificity (respectively 98.8% and 97.4%) for predicting development of HIE. CONCLUSION: On the basis of clinical manifestations of asphyxic neonatals, detecting the level of urinary S100B within three days and the first day urinary lactate/creatinine ratio may be of important value in early diagnosis and grading of HIE.
