[Clinical analysis of pediatric SARS cases in Beijing].
OBJECTIVE
To study clinical characteristics of pediatric SARS cases in Beijing.


METHODS
Eighteen pediatric cases with SARS diagnosed on admission were analyzed. The cases were admitted to Beijing Children's Hospital and Ditan Hospital (pediatric ward) from April 8 to May 12.


RESULTS
The 18 children aged 5 months to 15 years (10 male and 8 female) had epidemiologically linked findings. Fourteen cases had close contact with SARS patients. Four cases were living in the community where adult SARS patients were found. All the 18 patients but one presented with fever and cough. Most of them had high fever, 2 cases had bradycardia, 2 had diarrhea, and another 2 had tachypnea. Malaise and headache were noted only in 3 cases respectively which were much less frequently seen than in adult patients. Symptoms and signs of the children were much less severe and aggressive than adults cases. Thirteen children had chest radiographic consolidation. Of them, 9 cases had progressive changes after admission, then improved quickly. We did not find significant lower hemoglobin and platelet levels. Most patients had leukopenia and lymphopenia. Serologic test was performed for 15 cases and 8 were positive for SARS virus-IgG and 6 for IgM antibody. Of the 4 cases who had close contact with SARS adults and without chest radiograph abnormal findings, 3 were negative for SARS virus-antibodies. Part of the patients had temporary abnormality of myocardial enzyme and liver function. All these children finally had rapid improvement on chest radiograph. The patients were treated with antiviral agents and corticosteroid. Only two cases required oxygen therapy. No child needed assisted ventilation and no death, nor lung fibrosis occurred. After hospitalization, all patients were improved and discharged when this paper was being written. The average hospital stay of these patients was 14.6 days (6 - 22 days).


CONCLUSIONS
Compared with adults, pediatric SARS patients seemed to have their own clinical characteristics. The disease in children had lower severity and infectivity than that in adults. The mechanisms of the disease in children should be studied in well-designed clinical trials. Cases like the 4 children who had close contact with SARS adult patients but without chest radiographic changes deserve further studies with the help of more reliable and sensitive etiologic tests.
Li
Zhong-zhi
ZZ
Beijing Children's Hospital Affiliated to Capital University of Medical Sciences, Beijing 100045, China.
Shen
Kun-ling
KL
Wei
Xin-miao
XM
Wang
Hui-ling
HL
Lu
Jin
J
Tian
Hong
H
Sun
Guo-qiang
GQ
Zeng
Jin-jin
JJ
Hu
Ying-hui
YH
Zhao
Shun-ying
SY
Yin
Ju
J
Feng
Xue-li
XL
Jiang
Zai-fang
ZF
Yang
Yong-hong
YH
D000293:Adolescent; D000914:Antibodies, Viral / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D002681:China; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011859:Radiography; D045473:Severe acute respiratory syndrome-related coronavirus / Q000276:immunology*; D045169:Severe Acute Respiratory Syndrome / Q000473:pathology* / Q000628:therapy / Q000821:virology; D016896:Treatment Outcome
D000914:Antibodies, Viral