重症儿科新冠肺炎并发急性呼吸窘迫综合征:叙述性综述

Hui-xia Wang, Y. Qi, L. Qian
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引用次数: 1

摘要

这种新型冠状病毒自12月19日被发现以来,迅速成为全球大流行。SARS-CoV-2是一种乙型冠状病毒,主要感染表达血管紧张素转换酶2 (ACE2)受体的细胞,引起肺泡损伤和肺部过度炎症,严重者可引起弥漫性肺泡损伤和血栓形成。临床表现从轻度肺炎到重症,甚至死亡。儿童感染的患病率与成人相似,但症状轻微甚至无症状,其中以发烧和咳嗽为最常见的症状。然而,也有儿童被送入重症监护病房(ICU)甚至死亡的报告。其中,急性呼吸窘迫综合征(acute respiratory distress syndrome, ARDS)是常见的并发症,死亡率高。目前还没有针对新型冠状病毒肺炎的特异性药物,大量的临床试验正在进行中,以寻找最合适的治疗方法。呼吸支持仍是新型冠状病毒急性呼吸窘迫综合征的基本管理措施。本文就重症小儿冠状病毒病19合并ARDS的流行病学、发病机制、临床表现、诊断及治疗方法进展进行综述,希望在新型冠状病毒继续传播的情况下,临床医生能够更好地了解、诊断和治疗儿科患者。©儿科医学。版权所有。
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Severe pediatric COVID-19 with acute respiratory distress syndrome: a narrative review
The novel coronavirus has rapidly arisen to be a global pandemic since its discovery in December 19th. SARS-CoV-2, a type of betacoronavirus, mainly infects cells which express angiotensin-converting enzyme 2 (ACE2) receptors, causing alveolar damage and excessive inflammation in the lungs, and it can even cause diffuse alveolar damage and thrombosis in severe cases. The clinical manifestations range from mild pneumonia to severe illness, and even death. The prevalence of infection in children is similar to that of adults, though the symptoms are mild or even asymptomatic, among them, fever and cough are the most common symptoms. However, there are also reports of admission to the intensive care unit (ICU) or even death in children. Among them, acute respiratory distress syndrome (ARDS) is a common complication, with high mortality rates. Currently there are no specific drugs for the novel coronavirus pneumonia, and a large number of clinical trials are underway to search out the most suitable treatment. Respiratory support is still the basic management for ARDS induced by the novel coronavirus. This review summarizes the epidemiology, pathogenesis, clinical manifestations, diagnosis and progress of treatment methods in severe pediatric coronavirus disease 19 with ARDS, hoping that when the novel coronavirus continues to spread, clinicians can better understand, diagnose and treat the pediatric patients. © Pediatric Medicine. All rights reserved.
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