To understand the epidemiological and clinical features of the symptomatic and asymptomatic pediatric cases of COVID-19,we carried out a prospective study in Shanghai during the period of January 19 to April 30,2020.A...To understand the epidemiological and clinical features of the symptomatic and asymptomatic pediatric cases of COVID-19,we carried out a prospective study in Shanghai during the period of January 19 to April 30,2020.A total of 49 children(mean age 11.5±5.12 years)confirmed with SARS-CoV-2 infection were enrolled in the study,including 11(22.4%)domestic cases and 38(77.6%)imported cases.Nine(81.8%)local cases and 12(31.6%)imported cases had a definitive epidemiological exposure.Twenty-eight(57.1%)were symptomatic and 21(42.9%)were asymptomatic.Neither asymptomatic nor symptomatic cases progressed to severe diseases.The mean duration of viral shedding for SARS-CoV-2 in upper respiratory tract was 14.1±6.4 days in asymptomatic cases and 14.8±8.4 days in symptomatic cases(P>0.05).Forty-five(91.8%)cases had viral RNA detected in stool.The mean duration of viral shedding in stool was 28.1±13.3 days in asymptomatic cases and 30.8±18.6 days in symptomatic participants(P>0.05).Children<7 years shed viral RNA in stool for a longer duration than school-aged children(P<0.05).Forty-three(87.8%)cases had seropositivity for antibodies against SARS-CoV-2 within 1–3 weeks after confirmation with infection.In conclusion,asymptomatic SARS-CoV-2 infection may be common in children in the community during the COVID-19 pandemic wave.Asymptomatic cases shed viral RNA in a similar pattern as symptomatic cases do.It is of particular concern that asymptomatic individuals are potentially seed transmission of SARS-CoV-2 and pose a challenge to disease control.展开更多
Children with Coronavirus Disease 2019(COVID-19) were reported to show milder symptoms and better prognosis than their adult counterparts, but the difference of immune response against SARS-CoV-2 between children and ...Children with Coronavirus Disease 2019(COVID-19) were reported to show milder symptoms and better prognosis than their adult counterparts, but the difference of immune response against SARS-CoV-2 between children and adults hasn’t been reported. Therefore we initiated this study to figure out the features of immune response in children with COVID-19.Sera and whole blood cells from 19 children with COVID-19 during different phases after disease onset were collected.The cytokine concentrations, SARS-CoV-2 S-RBD or N-specific antibodies and T cell immune responses were detected respectively. In children with COVID-19, only 3 of 12 cytokines were increased in acute sera, including interferon(IFN)-cinduced protein 10(IP10), interleukin(IL)-10 and IL-16. We observed an increase in T helper(Th)-2 cells and a suppression in regulatory T cells(Treg) in patients during acute phase, but no significant response was found in the IFN-cproducing or tumor necrosis factor(TNF)-a-producing CD8?T cells in patients. S-RBD and N IgM showed an early induction, while S-RBD and N IgG were prominently induced later in convalescent phase. Potent S-RBD IgA response was observed but N IgA seemed to be inconspicuous. Children with COVID-19 displayed an immunophenotype that is less inflammatory than adults, including unremarkable cytokine elevation, moderate CD4?T cell response and inactive CD8?T cell response, but their humoral immunity against SARS-CoV-2 were as strong as adults. Our finding presented immunological characteristics of children with COVID-19 and might give some clues as to why children develop less severe disease than adults.展开更多
Objective:To describe the information technology and artificial intelligence support in management experiences of the pediatric designated hospital in the wave of COVID-19 in Shanghai.Methods:We retrospectively conclu...Objective:To describe the information technology and artificial intelligence support in management experiences of the pediatric designated hospital in the wave of COVID-19 in Shanghai.Methods:We retrospectively concluded the management experiences at the largest pediatric designated hospital from March 1st to May 11th in 2022 in Shanghai.We summarized the application of Internet hospital,face recognition technology in outpatient department,critical illness warning system and remote consultation system in the ward and the structed electronic medical record in the inpatient system.We illustrated the role of the information system through the number and prognosis of patients treated.Results:The COVID-19 designated hospitals were built particularly for critical patients requiring high-level medical care,responded quickly and scientifically to prevent and control the epidemic situation.From March 1st to May 11th,2022,we received and treated 768 children confirmed by positive RT-PCR and treated at our center.In our management,we use Internet Information on the Internet Hospital,face recognition technology in outpatient department,critical illness warning system and remote consultation system in the ward,structed electronic medical record in the inpatient system.No deaths or nosocomial infections occurred.The number of offline outpatient visits dropped,from March to May 2022,146,106,48,379,57,686 respectively.But the outpatient volume on the internet hospital increased significantly(3,347 in March 2022 vs.372 in March 2021;4,465 in April 2022 vs.409 in April 2021;4,677 in May 2022 vs.538 in May 2021).Conclusions:Information technology and artificial intelligence has provided significant supports in the management.The system might optimize the admission screening process,increases the communication inside and outside the ward,achieves early detection and diagnosis,timely isolates patients,and timely treatment of various types of children.展开更多
基金supported by a grant from Science and Technology Commission of Shanghai Municipality(Grant number:20JC1410203)a grant from Shanghai Municipal Health Commission(Grant Number:202040099)。
文摘To understand the epidemiological and clinical features of the symptomatic and asymptomatic pediatric cases of COVID-19,we carried out a prospective study in Shanghai during the period of January 19 to April 30,2020.A total of 49 children(mean age 11.5±5.12 years)confirmed with SARS-CoV-2 infection were enrolled in the study,including 11(22.4%)domestic cases and 38(77.6%)imported cases.Nine(81.8%)local cases and 12(31.6%)imported cases had a definitive epidemiological exposure.Twenty-eight(57.1%)were symptomatic and 21(42.9%)were asymptomatic.Neither asymptomatic nor symptomatic cases progressed to severe diseases.The mean duration of viral shedding for SARS-CoV-2 in upper respiratory tract was 14.1±6.4 days in asymptomatic cases and 14.8±8.4 days in symptomatic cases(P>0.05).Forty-five(91.8%)cases had viral RNA detected in stool.The mean duration of viral shedding in stool was 28.1±13.3 days in asymptomatic cases and 30.8±18.6 days in symptomatic participants(P>0.05).Children<7 years shed viral RNA in stool for a longer duration than school-aged children(P<0.05).Forty-three(87.8%)cases had seropositivity for antibodies against SARS-CoV-2 within 1–3 weeks after confirmation with infection.In conclusion,asymptomatic SARS-CoV-2 infection may be common in children in the community during the COVID-19 pandemic wave.Asymptomatic cases shed viral RNA in a similar pattern as symptomatic cases do.It is of particular concern that asymptomatic individuals are potentially seed transmission of SARS-CoV-2 and pose a challenge to disease control.
基金supported by grants specific for Coronavirus Disease 2019 from the Children’s Hospital of Fudan University (Grant No. EKXGZX006)。
文摘Children with Coronavirus Disease 2019(COVID-19) were reported to show milder symptoms and better prognosis than their adult counterparts, but the difference of immune response against SARS-CoV-2 between children and adults hasn’t been reported. Therefore we initiated this study to figure out the features of immune response in children with COVID-19.Sera and whole blood cells from 19 children with COVID-19 during different phases after disease onset were collected.The cytokine concentrations, SARS-CoV-2 S-RBD or N-specific antibodies and T cell immune responses were detected respectively. In children with COVID-19, only 3 of 12 cytokines were increased in acute sera, including interferon(IFN)-cinduced protein 10(IP10), interleukin(IL)-10 and IL-16. We observed an increase in T helper(Th)-2 cells and a suppression in regulatory T cells(Treg) in patients during acute phase, but no significant response was found in the IFN-cproducing or tumor necrosis factor(TNF)-a-producing CD8?T cells in patients. S-RBD and N IgM showed an early induction, while S-RBD and N IgG were prominently induced later in convalescent phase. Potent S-RBD IgA response was observed but N IgA seemed to be inconspicuous. Children with COVID-19 displayed an immunophenotype that is less inflammatory than adults, including unremarkable cytokine elevation, moderate CD4?T cell response and inactive CD8?T cell response, but their humoral immunity against SARS-CoV-2 were as strong as adults. Our finding presented immunological characteristics of children with COVID-19 and might give some clues as to why children develop less severe disease than adults.
基金Evaluation Study on Fudan Pediatric Medical Consortium's Response to Public Health Emergencies Based on the Prevention and Control of COVID-19 of Shanghai Municipal Health Commission under Grant No.202150028Practical Research on Medical Management of Integrated Paediatric COVID-19 Designated Hospital in peacetime and wartime of Shanghai Shenkang Hospital Development Center under Grant No.2022SKMR-17Research on the Exploration and Application of the"4s"Management Mode of Pediatric Medical Safety under the Normalized Epidemic Prevention and Control of Shanghai Shenkang Hospital Development Center under Grant No.SHDC12021620.
文摘Objective:To describe the information technology and artificial intelligence support in management experiences of the pediatric designated hospital in the wave of COVID-19 in Shanghai.Methods:We retrospectively concluded the management experiences at the largest pediatric designated hospital from March 1st to May 11th in 2022 in Shanghai.We summarized the application of Internet hospital,face recognition technology in outpatient department,critical illness warning system and remote consultation system in the ward and the structed electronic medical record in the inpatient system.We illustrated the role of the information system through the number and prognosis of patients treated.Results:The COVID-19 designated hospitals were built particularly for critical patients requiring high-level medical care,responded quickly and scientifically to prevent and control the epidemic situation.From March 1st to May 11th,2022,we received and treated 768 children confirmed by positive RT-PCR and treated at our center.In our management,we use Internet Information on the Internet Hospital,face recognition technology in outpatient department,critical illness warning system and remote consultation system in the ward,structed electronic medical record in the inpatient system.No deaths or nosocomial infections occurred.The number of offline outpatient visits dropped,from March to May 2022,146,106,48,379,57,686 respectively.But the outpatient volume on the internet hospital increased significantly(3,347 in March 2022 vs.372 in March 2021;4,465 in April 2022 vs.409 in April 2021;4,677 in May 2022 vs.538 in May 2021).Conclusions:Information technology and artificial intelligence has provided significant supports in the management.The system might optimize the admission screening process,increases the communication inside and outside the ward,achieves early detection and diagnosis,timely isolates patients,and timely treatment of various types of children.
