Cases of Covid-19 infection in children at Yunnan hospital, Kunming, China.
Case report.
Case 1 ➡
Identity : Boy, 4 year old.
Main complaint : cough and cold since 3 days SMRS.
Contact History :
- Grandmother and grandfather just returned from the Wuhan city.
- Grandfather, grandmother, father and mother positive Covid-19.
Abnormal laboratory results :
- Leukocytes : 5870/µl
- Neutrophils : 32.8% (⬇)
- Lymphogranulocytes : 53.4% (⬆)
- Monocytes : 12.7% (⬆)
- CRP : 11.2 mg / L (⬆)
Pulmonary CT scan :
- Spot the 2 upper lobes, right lower lobe, left lower lobe.
- Suggestive of infection process.
RT-PCR : DNA positive SARSCov-2 (Covid-19).
CT scan image of case 1 |
Case 2 ➡
Identity : Girl, 4 year old.
Main complaint : -
Contact History :
- A 10 day contact history with a positive case of Covid-19.
- Cousin of patient case 1.
Abnormal laboratory results :
- Leukocytes : 6680 / µl
- Lymphogranulocytes : 42.3% (⬆)
Pulmonary CT scan : increased bronchovascular branching on both sides of the lung.
RT-PCR : initially negative, then positive after 1 day.
CT scan image of case 2 |
The main transmission source of COVID-19 in pediatric patients :
- Close contact with COVID-19 positive patients, including asymptomatic cases.
- Aerosol transmission.
- Faecal-oral route.
- Mother to child transmission.
The incubation period for COVID-19 in children : 1-14 days with an average of 3-7 days.
In pediatric patients, symptoms are generally mild :
- Without fever or pneumonia, so it has a good prognosis.
- Rarely found abnormalities in liver function, CRP or kidney function such as adult cases.
Research has shown that Angiotensin Converting Enzyme-2 (ACE2) is an important component for SARSCoV-2 entering lung epithelial cells as receptors. This affects the symptoms of pediatric patients who are lighter because the development of ACE2 is still not perfect.
Symptoms of inflammation are milder because the adaptive immune response is not yet fully developed.
Diagnosis.
DNA detection by RT-PCR is a mandatory diagnosis of COVID-19 with high specificity, but the sensitivity is low so that a CT scan is needed.
Conclusion.
- COVID-19 cases have symptoms that tend to be asymptomatic or even mild.
- Precautions should be taken in pediatric patients with a history of contact with COVID-19 positive people.
- Detection must be made on all family members.
- RT-PCR examination results can be negative, so an immediate CT scan is very important to avoid false negatives.
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