A follow-up study of children infected with SARS-CoV-2 from western China.

Coronavirus asymptomatic infection children western China

Journal

Annals of translational medicine
ISSN: 2305-5839
Titre abrégé: Ann Transl Med
Pays: China
ID NLM: 101617978

Informations de publication

Date de publication:
May 2020
Historique:
entrez: 23 6 2020
pubmed: 23 6 2020
medline: 23 6 2020
Statut: ppublish

Résumé

To clarify the characteristic and the duration of positive nucleic acid in children infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including asymptomatic children. A total of 32 children confirmed with SARS-CoV-2 infection between January 24 and February 12, 2020 from four provinces in western China were enrolled in this study and followed up until discharge and quarantine 14 days later. Eleven children (34%) were asymptomatic, among whom six children had normal computed tomographic (CT) scan images. Age and gender were not associated with clinical symptoms or the results of CT scan in children infected with SARS-CoV-2. The concentrations of white blood cells and neutrophils were higher in children with asymptomatic infection than in children with clinical symptoms or CT abnormalities. Patients who presented with CT abnormalities had lower D-dimer or lower total bilirubin than those who had normal CT scan but clinical symptoms. All children recovered and no one died or was admitted to the pediatric intensive care unit (PICU). The mean duration of positive SARS-CoV-2 nucleic acid was 15.4 (SD =7.2) days and similar for both asymptomatic children and children with symptoms or CT abnormalities. We found a significant negative correlation between the lymphocyte count and the duration of positive nucleic acid test. Children with asymptomatic infection should be quarantined for the same duration as symptomatic patients infected with SARS-CoV-2. The clinical significance and mechanism behind the negative correlation between the number of lymphocytes and the duration of positive SARS-CoV-2 needs further study.

Sections du résumé

BACKGROUND BACKGROUND
To clarify the characteristic and the duration of positive nucleic acid in children infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including asymptomatic children.
METHODS METHODS
A total of 32 children confirmed with SARS-CoV-2 infection between January 24 and February 12, 2020 from four provinces in western China were enrolled in this study and followed up until discharge and quarantine 14 days later.
RESULTS RESULTS
Eleven children (34%) were asymptomatic, among whom six children had normal computed tomographic (CT) scan images. Age and gender were not associated with clinical symptoms or the results of CT scan in children infected with SARS-CoV-2. The concentrations of white blood cells and neutrophils were higher in children with asymptomatic infection than in children with clinical symptoms or CT abnormalities. Patients who presented with CT abnormalities had lower D-dimer or lower total bilirubin than those who had normal CT scan but clinical symptoms. All children recovered and no one died or was admitted to the pediatric intensive care unit (PICU). The mean duration of positive SARS-CoV-2 nucleic acid was 15.4 (SD =7.2) days and similar for both asymptomatic children and children with symptoms or CT abnormalities. We found a significant negative correlation between the lymphocyte count and the duration of positive nucleic acid test.
CONCLUSIONS CONCLUSIONS
Children with asymptomatic infection should be quarantined for the same duration as symptomatic patients infected with SARS-CoV-2. The clinical significance and mechanism behind the negative correlation between the number of lymphocytes and the duration of positive SARS-CoV-2 needs further study.

Identifiants

pubmed: 32566560
doi: 10.21037/atm-20-3192
pii: atm-08-10-623
pmc: PMC7290618
doi:

Types de publication

Journal Article

Langues

eng

Pagination

623

Informations de copyright

2020 Annals of Translational Medicine. All rights reserved.

Déclaration de conflit d'intérêts

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/atm-20-3192). The authors have no conflicts of interest to declare.

Références

Respirology. 2003 Nov;8 Suppl:S9-14
pubmed: 15018127
N Engl J Med. 2020 Mar 26;382(13):1199-1207
pubmed: 31995857
N Engl J Med. 2020 Feb 20;382(8):727-733
pubmed: 31978945
Clin Infect Dis. 2020 Sep 12;71(6):1547-1551
pubmed: 32112072
N Engl J Med. 2020 Feb 27;382(9):872-874
pubmed: 31991079
N Engl J Med. 2020 Apr 23;382(17):1663-1665
pubmed: 32187458
JAMA. 2020 Feb 25;323(8):707-708
pubmed: 31971553
N Engl J Med. 2020 Mar 19;382(12):1177-1179
pubmed: 32074444
Lancet. 2020 Feb 15;395(10223):497-506
pubmed: 31986264
BMC Infect Dis. 2017 Sep 11;17(1):615
pubmed: 28893197
World J Pediatr. 2020 Jun;16(3):223-231
pubmed: 32034659
JAMA. 2020 Apr 21;323(15):1502-1503
pubmed: 32105304
Lancet Respir Med. 2020 Apr;8(4):420-422
pubmed: 32085846
JAMA. 2020 Feb 25;323(8):709-710
pubmed: 31999307
N Engl J Med. 2020 Apr 2;382(14):1370-1371
pubmed: 32163697
JAMA. 2020 Mar 17;323(11):1092-1093
pubmed: 32031568
Lancet. 2020 Feb 29;395(10225):689-697
pubmed: 32014114
BMJ. 2020 Mar 12;368:m1036
pubmed: 32165426
Lancet. 2020 Feb 15;395(10223):507-513
pubmed: 32007143
JAMA. 2020 Apr 7;323(13):1313-1314
pubmed: 32058570

Auteurs

Hongmei Xu (H)

Department of Infection, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.
National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China.
Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.

Enmei Liu (E)

National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China.
Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.
Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.

Jun Xie (J)

National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China.
Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.
Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.

Rosalind L Smyth (RL)

UCL Great Ormond St Institute of Child Health, Great Ormond Street Hospital, London, UK.

Qi Zhou (Q)

The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, China.

Ruiqiu Zhao (R)

Department of Infection, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.
National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China.
Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.

Na Zang (N)

National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China.
Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.
Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.

Xiaoru Long (X)

Department of Infection, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.
National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China.
Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.

Yuyi Tang (Y)

National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China.
Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.
Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.

Janne Estill (J)

Institute of Global Health, University of Geneva, Geneva, Switzerland; Institute of Mathematical Statistics and Actuarial Science, University of Bern, Bern, Switzerland.

Shu Yang (S)

College of Medical Information Engineering, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.

Jing Zhu (J)

Department of Infection, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.
National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China.
Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.

Xiaofeng Yan (X)

Department of Infection, Chongqing Public Health Medical Center, Chongqing 400036, China.

Fang Gong (F)

Department of Pediatrics, Yongchuan Hospital of Chongqing Medical University, Chongqing 402460, China.

Wenguang Tian (W)

Department of Pediatrics, Yongchuan Hospital of Chongqing Medical University, Chongqing 402460, China.

Xiaqia Zhou (X)

Department of Pediatrics, Yongchuan Hospital of Chongqing Medical University, Chongqing 402460, China.

Yunbo Mo (Y)

Department of Pediatrics, Three Gorges Hospital, Chongqing University, Chongqing 404100, China.

Hongzhou Xiao (H)

Department of Pediatrics, Three Gorges Hospital, Chongqing University, Chongqing 404100, China.

Zhengzhen Tang (Z)

Department of Pediatrics, Third Affiliated Hospital of Zunyi Medical University, Zunyi 563003, China.

Yanni Chen (Y)

Department of Infection, Xi'an Children's Hospital, the Affiliated Children's Hospital of Xi'an Jiaotong University, Shaanxi 710003, China.

Yi Wang (Y)

Department of Infection, Xi'an Children's Hospital, the Affiliated Children's Hospital of Xi'an Jiaotong University, Shaanxi 710003, China.

Yuxia Cui (Y)

Department of Pediatrics, Guizhou Provincial People's Hospital, Guiyang 550002, China.

Xiuling Fang (X)

Department of Pediatrics, Tongchuan Mining Bureau Central Hospital, Tongchuan 727000, China.

Feiyu Li (F)

Department of Pediatrics, Xi'an Eighth Hospital, Xi'an 710065, China.

Yong Tian (Y)

Department of Pediatrics, The People's Hospital of Xiushan County, Chongqing 409900, China.

Peibo Li (P)

Department of Pediatrics, The People's Hospital of Xiushan County, Chongqing 409900, China.

Quanmin Deng (Q)

Department of Pediatrics, The People's Hospital of Deyang City, Deyang 618000, China.

Chongsong Ren (C)

Department of Pediatrics, Nanchong Central Hospital, Nanchong 637000, China.

Ronghui He (R)

Department of Pediatrics, Nanchong Central Hospital, Nanchong 637000, China.

Yi Li (Y)

Department of Pediatrics, Suining Central Hospital, Suining 629000, China.

Hong Qin (H)

Department of Pediatrics, The People's Hospital of Fengdu County, Chongqing 408200, China.

Aiguo Wang (A)

Department of Pediatrics, The People's Hospital of Kaizhou District, Chongqing 405400, China.

Hongli Deng (H)

Department of Pediatrics, The People's Hospital of Hechuan District, Chongqing 401520, China.

Jianguo Wu (J)

Department of Pediatrics, The People's Hospital of Fengjie County, Chongqing 404600, China.

Wenbo Meng (W)

Special Minimally Invasive Surgery Department, the First Hospital of Lanzhou University, Lanzhou 730000, China.

Weiguo Li (W)

National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China.
Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.
Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.

Yao Zhao (Y)

National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China.
Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.
Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.

Zhengxiu Luo (Z)

National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China.
Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.
Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.

Zijun Wang (Z)

Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.

Yaolong Chen (Y)

Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.

Gary Wing Kin Wong (GWK)

Department of Pediatrics, The Chinese University of Hong Kong, Hong Kong, China.

Qiu Li (Q)

National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China.
Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.
Department of Nephrology, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.

Classifications MeSH