目的:提供临床特征的全面描述,生化特性,以及90天大的COVID-19婴儿的结局。此外,评估疾病的严重程度并提出有效的管理途径。
方法:为期三年的回顾性单中心研究。患者数据包括年龄、性别,症状,合并症,血液和尿液检查结果,文化,入场,逗留时间,疗法,重症监护室入院,和死亡率。
结果:本研究共纳入274例患者,由55%的男性组成。其中,60例患者(22%)年龄在29天以下,而214人(78%)在29至90天的年龄范围内。SARS-CoV-2感染的总发生率为每10000例儿科急诊科入院0.28例。血液炎症指标无明显异常,并且没有记录到血培养阳性。少于1%的婴儿出现尿路感染,尿培养阳性,1.5%的患者并发RSV感染。新生儿住院率为83%,婴儿住院率为67%,两个年龄组的中位住院时间(LOS)为48小时。没有患者需要进入儿科或新生儿重症监护病房,只有一个需要高流量鼻套管(HFNC)。没有观察到继发性严重细菌感染,所有住院患者均出院,无短期后遗症。没有死亡报告。
结论:患有COVID-19的婴儿通常表现出轻度或无症状的疾病形式,在大多数情况下,家庭管理是一个可行的选择。验血,指示轻度炎症反应,主要推荐给有疾病症状的儿童。没有明显疾病或合并症的婴儿住院预防措施被认为是不必要的。鉴于婴儿使用COVID-19的经历的演变性质,保持高水平的临床怀疑仍然是当务之急。
OBJECTIVE: To provide a comprehensive description of the clinical features, biochemical characteristics, and outcomes of infants up to 90 days old with COVID-19. Moreover, to assess the severity of the disease and propose an effective management pathway.
METHODS: Retrospective single-center study spanning three years. Patient data includes age, sex, symptoms, comorbidities, blood and urine test results, cultures, admission, length of stay, therapies, intensive care unit admission, and mortality.
RESULTS: A total of 274 patients were enrolled in the study, comprising 55% males. Among them, 60 patients (22%) were under the age of 29 days, while 214 (78%) fell within the 29 to 90 days age range. The overall incidence of SARS-CoV-2 infections was 0.28 per 10,000 Pediatric Emergency Department admissions. Blood inflammatory markers showed no significant abnormalities, and there were no recorded instances of positive blood cultures. Less than 1% of infants showed urinary tract infections with positive urine cultures, and 1.5% of patients had a concurrent RSV infection. Hospitalization rates were 83% for neonates and 67% for infants, with a median length of stay (LOS) of 48 h for both age groups. None of the patients required admission to the Pediatric or Neonatal Intensive Care Unit, and only one required High Flow Nasal Cannula (HFNC). No secondary serious bacterial infections were observed, and all hospitalized patients were discharged without short-term sequelae. No deaths were reported.
CONCLUSIONS: Infants with COVID-19 generally exhibit milder or asymptomatic forms of the disease, making home management a viable option in most cases. Blood tests, indicative of a mild inflammatory response, are recommended primarily for children showing symptoms of illness. Hospitalization precautions for infants without apparent illness or comorbidities are deemed unnecessary. Given the evolving nature of experiences with COVID-19 in infants, maintaining a high level of clinical suspicion remains imperative.