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http://conacyt.repositorioinstitucional.mx/jspui/handle/1000/2121| Clinical analysis and early differential diagnosis of suspected pediatric patients with 2019 novel coronavirus infection | |
| Denggao Peng. Jing Zhang. Yingqi Xu. Zhichao Liu. Pengyao Wu. | |
| Acceso Abierto | |
| Atribución-NoComercial-SinDerivadas | |
| 10.1101/2020.04.07.20057315 | |
| Abstract Background: Early differential diagnosis of suspected pediatric patients is difficult during the 2019-nCoV epidemic. Objective: To identify clinical characteristics and key points of early differential diagnosis. Methods: A retrospective analysis was performed on suspected pediatric cases. Results:A total of 77 suspected cases were admitted from Jan 22nd to Mar 1st. Compared with non-2019-nCoV group (n=33),2019-nCoV confirmed group (n=35) had fewer fever (OR[95% CI] 0.39[0.242 to 0.628];P<.001) and symptoms of ARI (0.454[0.287 to 0.719];P<.001),more asymptomatic (15.086[2.117 to 107.475];P<.001), and more family cluster infections (5.469[2.405 to 12.433]; P<.001),while chest CT had more positive findings of viral pneumonia (1.813[1.131 to 2.908];P=.014).There were significant statistical differences between the two groups in age (7.2[3.9 to 11.4] vs 5[2.1 to 7.8];P=.031),body temperature (36.7[36.2 to 36.9] vs 37[36.7 to 37.9];P=.001), heart rate ([97.1 and 16.8] vs [109.7 and 15.6];P=.002),percentage ([39.4 and 14.9] vs [52.5 and 17.5]; P=.001) and count (2.25[1.43 to 3.53] vs 3.33[2.8 to 5.18];P=.007) of neutrophil, percentage (45.3[39.2 to 56.6] vs 33.2[22.7 to 42.5];P=.001) of lymphocyte,hs-CRP (5.52[1.1 to 9.04] vs 9.04[7.35 to 9.54];P=.002) and PCT (0.05[0.03 to 0.08] vs 0.1[0.05 to 0.21];P<.001),while gender (42.9% vs 57.6%;P=.332),respiratory rate (22[20 to 22] vs 22[20 to 24];P=.092),WBC (5.37[4.67 to 8.08] vs 6.94[5.72 to 8.87];P=.198), lymphocyte count (2.68[1.99 to 4.01] vs 2.26[1.66 to 2.92];P=.096),Hb (128[124 to 142] vs 130[119 to 137];P=.572) and PLT ([279.1 and 77.5] vs [263.4 and 65.1];P=.37) were statistically insignificant. Conclusions: Asymptoms or mild symptoms,positive CT findings and family cluster infection are the main clinical characteristics of infected pediatric patients. The CBC, hs-CRP and PCT can provide an important basis for early differential diagnosis. Compared with other non-bacterial infections,hs-CRP and PCT in 2019-nCoV infection are reduced,but further evidence is needed to support whether their reduction is specific. Keywords: 2019 novel coronavirus;acute respiratory infection; pediatric;differential diagnosis;suspected infection. Abbreviations:2019-nCoV,2019 novel coronavirus;CT,computed tomography; RT-PCR,real-time reverse transcriptase polymerase chain reaction;IQR,interquartile range;OR,odds ratio;CI,confidence interval;SD,standard deviation;ARI,acute respiratory infection; CAP,community-acquired pneumonia;RSV, respiratory syncytial virus; MP, mycoplasma pneumoniae; INF A,B,influenza A,B;CBC,complete blood count;WBC,white blood cell;N%, percentage of neutrophil; L%, percentage of lymphocyte; Hb, Hemoglobin;PLT, platelet; hs-CRP,high sensitivity C-reactive protein; PCT, procalcitonin. | |
| www.medrxiv.org | |
| 2020 | |
| Artículo | |
| https://www.medrxiv.org/content/10.1101/2020.04.07.20057315v1.full.pdf | |
| Inglés | |
| VIRUS RESPIRATORIOS | |
| Aparece en las colecciones: | Artículos científicos |
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