Diagnosis, treatment, and prevention of 2019 novel coronavirus infection in children: experts’ consensus statement

Author(s): Kunling Shen ¹ ^, , Yonghong Yang ² ^, , Tianyou Wang ³ , Dongchi Zhao ⁴ ^, , Yi Jiang ⁵ , Runming Jin ⁶ , Yuejie Zheng ⁷ , Baoping Xu ¹ , Zhengde Xie ² , Likai Lin ⁸ , Yunxiao Shang ⁹ , Xiaoxia Lu ¹⁰ , Sainan Shu ¹¹ , Yan Bai ⁶ , Jikui Deng ¹² , Min Lu ¹³ , Leping Ye ¹⁴ , Xuefeng Wang ¹⁵ , Yongyan Wang ¹⁶ , Liwei Gao ¹ , China National Clinical Research Center for Respiratory Diseases, National Center for Children’s Health, Beijing, China, Group of Respirology, Chinese Pediatric Society, Chinese Medical Association, Chinese Medical Doctor Association Committee on Respirology Pediatrics, China Medicine Education Association Committee on Pediatrics, Chinese Research Hospital Association Committee on Pediatrics, Chinese Non-government Medical Institutions Association Committee on Pediatrics, China Association of Traditional Chinese Medicine, Committee on Children’s Health and Medicine Research, China News of Drug Information Association, Committee on Children’s Safety Medication, Global Pediatric Pulmonology Alliance

Publication date (Electronic): 7 February 2020

Journal: World Journal of Pediatrics

Publisher: Springer Singapore

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Abstract

Since the outbreak of 2019 novel coronavirus infection (2019-nCoV) in Wuhan City, China, by January 30, 2020, a total of 9692 confirmed cases and 15,238 suspected cases have been reported around 31 provinces or cities in China. Among the confirmed cases, 1527 were severe cases, 171 had recovered and been discharged at home, and 213 died. And among these cases, a total of 28 children aged from 1 month to 17 years have been reported in China. For standardizing prevention and management of 2019-nCoV infections in children, we called up an experts’ committee to formulate this experts’ consensus statement. This statement is based on the Novel Coronavirus Infection Pneumonia Diagnosis and Treatment Standards (the fourth edition) (National Health Committee) and other previous diagnosis and treatment strategies for pediatric virus infections. The present consensus statement summarizes current strategies on diagnosis, treatment, and prevention of 2019-nCoV infection in children.

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Most cited references 24

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Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

Chaolin Huang, Yeming Wang, Xingwang Li … (2020)

Summary Background A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients. Methods All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not. Findings By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0–58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0–13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα. Interpretation The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies. Funding Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission.

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A Novel Coronavirus from Patients with Pneumonia in China, 2019

Na Zhu, Dingyu Zhang, Wenling Wang … (2020)

Summary In December 2019, a cluster of patients with pneumonia of unknown cause was linked to a seafood wholesale market in Wuhan, China. A previously unknown betacoronavirus was discovered through the use of unbiased sequencing in samples from patients with pneumonia. Human airway epithelial cells were used to isolate a novel coronavirus, named 2019-nCoV, which formed a clade within the subgenus sarbecovirus, Orthocoronavirinae subfamily. Different from both MERS-CoV and SARS-CoV, 2019-nCoV is the seventh member of the family of coronaviruses that infect humans. Enhanced surveillance and further investigation are ongoing. (Funded by the National Key Research and Development Program of China and the National Major Project for Control and Prevention of Infectious Disease in China.)

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Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study

Nanshan Chen, Min Zhou, Xuan Dong … (2022)

Summary Background In December, 2019, a pneumonia associated with the 2019 novel coronavirus (2019-nCoV) emerged in Wuhan, China. We aimed to further clarify the epidemiological and clinical characteristics of 2019-nCoV pneumonia. Methods In this retrospective, single-centre study, we included all confirmed cases of 2019-nCoV in Wuhan Jinyintan Hospital from Jan 1 to Jan 20, 2020. Cases were confirmed by real-time RT-PCR and were analysed for epidemiological, demographic, clinical, and radiological features and laboratory data. Outcomes were followed up until Jan 25, 2020. Findings Of the 99 patients with 2019-nCoV pneumonia, 49 (49%) had a history of exposure to the Huanan seafood market. The average age of the patients was 55·5 years (SD 13·1), including 67 men and 32 women. 2019-nCoV was detected in all patients by real-time RT-PCR. 50 (51%) patients had chronic diseases. Patients had clinical manifestations of fever (82 [83%] patients), cough (81 [82%] patients), shortness of breath (31 [31%] patients), muscle ache (11 [11%] patients), confusion (nine [9%] patients), headache (eight [8%] patients), sore throat (five [5%] patients), rhinorrhoea (four [4%] patients), chest pain (two [2%] patients), diarrhoea (two [2%] patients), and nausea and vomiting (one [1%] patient). According to imaging examination, 74 (75%) patients showed bilateral pneumonia, 14 (14%) patients showed multiple mottling and ground-glass opacity, and one (1%) patient had pneumothorax. 17 (17%) patients developed acute respiratory distress syndrome and, among them, 11 (11%) patients worsened in a short period of time and died of multiple organ failure. Interpretation The 2019-nCoV infection was of clustering onset, is more likely to affect older males with comorbidities, and can result in severe and even fatal respiratory diseases such as acute respiratory distress syndrome. In general, characteristics of patients who died were in line with the MuLBSTA score, an early warning model for predicting mortality in viral pneumonia. Further investigation is needed to explore the applicability of the MuLBSTA score in predicting the risk of mortality in 2019-nCoV infection. Funding National Key R&D Program of China.

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Author and article information

Contributors

Kunling Shen: kunlingshen1717@163.com

Yonghong Yang: yyh628628@sina.com

Dongchi Zhao: zhao_wh2004@hotmail.com

Journal

Journal ID (nlm-ta): World J Pediatr

Journal ID (iso-abbrev): World J Pediatr

Title: World Journal of Pediatrics

Publisher: Springer Singapore (Singapore )

ISSN (Print): 1708-8569

ISSN (Electronic): 1867-0687

Publication date (Electronic): 7 February 2020

Pages: 1-9

Affiliations

[1 ]GRID grid.24696.3f, ISNI 0000 0004 0369 153X, Department of Respiratory Medicine, Beijing Children’s Hospital, , Capital Medical University, ; Beijing, China

[2 ]GRID grid.24696.3f, ISNI 0000 0004 0369 153X, Beijing Pediatric Research Institute, Beijing Children’s Hospital, , Capital Medical University, ; Beijing, China

[3 ]GRID grid.24696.3f, ISNI 0000 0004 0369 153X, Center of Hematologic Oncology, , Beijing Children’s Hospital, Capital Medical University, ; Beijing, China

[4 ]GRID grid.413247.7, Department of Pediatrics, , Zhongnan Hospital of Wuhan University, ; Wuhan, China

[5 ]GRID grid.412632.0, ISNI 0000 0004 1758 2270, Department of Pediatrics, , Renmin Hospital of Wuhan University, ; Wuhan, China

[6 ]GRID grid.33199.31, ISNI 0000 0004 0368 7223, Department of Pediatrics, , Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, ; Wuhan, China

[7 ]GRID grid.452787.b, ISNI 0000 0004 1806 5224, Department of Respiratory Medicine, , Shenzhen Children’s Hospital, ; Shenzhen, China

[8 ]GRID grid.413247.7, Hospital Management Institute of Wuhan University, , Zhongnan Hospital of Wuhan University, ; Wuhan, China

[9 ]GRID grid.412467.2, ISNI 0000 0004 1806 3501, Department of Pediatric Respiratory, , Shengjing Hospital of China Medical University, ; Shenyang, China

[10 ]GRID grid.33199.31, ISNI 0000 0004 0368 7223, Department of Respiratory Medicine, , Wuhan Children’s Hospital, Tongji Medical College, Huazhong University of Science and Technology, ; Wuhan, China

[11 ]GRID grid.33199.31, ISNI 0000 0004 0368 7223, Department of Pediatrics, Tongji Hospital, Tongji Medical College, , Huazhong University of Science and Technology, ; Wuhan, China

[12 ]GRID grid.452787.b, ISNI 0000 0004 1806 5224, Department of Infectious Disease, , Shenzhen Children’s Hospital, ; Shenzhen, China

[13 ]Department of Respiratory Medicine, Children’s Hospital of Shanghai, Shanghai, China

[14 ]GRID grid.411472.5, ISNI 0000 0004 1764 1621, Department of Pediatrics, , Peking University First Hospital, ; Beijing, China

[15 ]GRID grid.477514.4, Department of Pediatrics, , Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, ; Shenyang, China

[16 ]GRID grid.410318.f, ISNI 0000 0004 0632 3409, Institute of Basic Research in Clinical Medicine, , China Academy of Chinese Medical Sciences, ; Beijing, China

Article

Publisher ID: 343

DOI: 10.1007/s12519-020-00343-7

PMC ID: 7090771

PubMed ID: 32034659

SO-VID: 152d121d-42e9-4e50-80b4-2d46fce3779b

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This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

Diagnosis, treatment, and prevention of 2019 novel coronavirus infection in children: experts’ consensus statement

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Novel Coronavirus Disease COVID-19

Most cited references 24

Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

A Novel Coronavirus from Patients with Pneumonia in China, 2019

Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study

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