Nat Med: Selected as the Cover Field impact first, was downloaded 320,000 times, Qi Sitang / Zhang Kang / Tang Jinling / Xia Huimin this result in the end answer edifice questions?

On March 13, 2020, Guangzhou WomenChildren'sMedical Center, Zhang Kang, Tang Jinling and Xia Huimin jointly newsletter in Nature Medicine online entitled "Features of pediatric SARS-CoV-2 infection and evidence evidence for persistent for For the first time in the world, 10 cases of SARS-CoV-2infectioncases in 10 children have been detailed in the world, confirmed by real-time reverse transcription PCR testing of SARS-CoV-2 RNAThe symptoms of these cases are nonspecific, no children need respiratory support or intensive care, and chest X-rays lack clear signs of pneumoniaIt is worth noting that even after the nasopharyngeal test was negative, eight children still tested positive for rectal swabs, increasing the likelihood of fecal transmissionThis article was selected as the cover of Nature Medicine in Aprilhas been downloaded 320,000 times as of June 16, 2020This paper score has become the most influential 1% of the 250,000 papers of all the world's leading magazines tracked by AltmetricIn addition, the score of the study, which ranked fourth in more than 100 research papers published in the last three months of Altmetric's Nature Medicine, set a new record for the highest score in pediatrics, and the score of the study continued to riseCoronary virus disease (
COVID-19) quickly gained global attention in 2019 due to the rapid increase in new casesThe new coronavirus infection is thought to be transmitted from animals and the pathogen has been identified as SARS-CoV-2By January 2020, the initial lysac swashean was infected with the virus through human-to-human transmissionSince January 2020, the virus has spread rapidly to large parts of China and other countriesNature Medicine cover articleso far, there is little information about SARS-CoV-2 infection in childrenThe study reported on the epidemiological and clinical characteristics of 10 children infected with SARS-CoV-2 and excreted by the gastrointestinal tract and respiratory tractthe chronological sequence and molecular test results of major epidemiological events in 10 pediatric patients diagnosed with SARS-CoV-2 infection (from Nature Medicine
by February 20, 2020, a total of 745 children and 3,174 adults were screened through nasopharyngeal swab swab swab real-time PCRscreening, most of whom had close contact with confirmed patients or family members who had reported family outbreaks in the past 2 weeksOverall, 10 children (1.3 per cent) and 111 adults (3.5 per cent) tested positiveAll ten child patients were admitted to hospitalOf the ten children, six were male and four were women, ranging in age from 2 months to 15 yearsFour patients had a clear history of contact with the confirmed patients, seven from a cluster of infected families, and seven had travelled to the epidemic area of Hubei Province 2 weeks before the infection beganadmission, seven people had a fever, but none of them were above 39 degrees CelsiusOther symptoms include cough (five children), sore throat (four children), nasal congestion (two children) and diarrhea (three children)A child has no symptoms at all (patient 4) No patient has other common symptoms of adult symptoms, such as drowsiness, difficulty breathing, muscle pain, headache, nausea, vomiting and disorientation In fact, none of them sought medical care Because of their history of contact, they are identified and diagnosed Altmetric index distribution composition these patients chest X-rays normal or only show edire of large lung traces, no one-sided or bilateral pneumonia Chest computed tomography (CT) scans showed isolated or multi-plaqueglass-like turbidity in 5 patients, but the other 5 cases were within the normal range Full blood cell count, urine and fecal analysis, clotting function, blood biochemical and infection biomarker testing were performed at the time of admission Almost all test results were normal in all but patient number 9 There are few cases of leukocyte reduction, leukocytic hyperactivity, lymphocytic reduction or elevated transaminase, which is common in adult patients All patients with influenza A viruses (H1N1, H3N2, H7N9), influenza B virus, respiratory syncytial virus, paravirus, adenovirus, SARS-CoV and MERS-CoV were negative in 9 patients (the tenth patient did not have cytokine testing from admission), 7 showed an increase in interleukin (IL)-17F, and 5 of them had an increase in IL-22 at the same time IL-6 elevated in 5 patients all patients were admitted to hospital with antiviral therapy for an oral spray of alpha-interferon (8,000 U, two sprays, three times a day) Patient 1 is the first case of pediatric SARS-CoV-2 infection diagnosed in Guangzhou, received 10 micrograms /kg-1 g/day per day, lasting 5 dd; No patients need respiratory support or intensive care researchers used real-time RT-PCR to sequence a series of nasopharyngeal and rectum swabs in chronological order, tracking the presence of the virus from the respiratory and gastrointestinal tracts in all 10 patients Patient 4 asymptomatic, but multiple tests are positive Patient 6 asymptomatic on the day of the positive nasopharyngeal swab test, and then the next day there is nasal congestion and nasal leakage The remaining eight patients tested positive shortly after the onset of symptoms In addition, eight out of ten patients had real-time RT-PCR-positive rectal swabs, indicating potential fecal virus excretion In addition, eight out of ten patients (patients 1-6, 8 and 10) showed continuous positive real-time RT-PCR for rectal swabs, but their nasopharyngeal tests were negative patients 2, 4, 7 and 10 were discharged after two consecutive real-time real-time negative RT-PCR tests (at least 24 hours apart) Repeat the nasopharyl swab and rectum swabs once a week after discharge from the hospital Patients 4 and 7 remained negative during follow-up, but patient 2 again tested positive for 13 d rectal swabs after discharge Interestingly, the mother of patient 2 was hospitalized for SARS-CoV-2 infection (COVID-19) and was discharged from another hospital at the same time, and her child tested positive for a rectal swab on the same day A similar phenomenon was observed in patient 10 He was admitted to the Eighth People's Hospital in Guangzhou from 27 January to 11 February and was discharged from hospital with two consecutive negative results of 24h nasopharyngeal and rectum swabs However, although his nasopharyngeal swab test was negative, his rectal swabs test again turned positive on 17 February and he was admitted again As of 20 February, all the remaining patients (patients 1, 3, 5, 6, 8 and 9) were still positive for rectal swabs and continued to be isolated and observed in hospital, despite their recovery and asymptomatic conditions the researchers used a cycle threshold (Ct) for continuous rectal and nasopharyngeal swab tests to roughly indicate the patient's viral load (inversely proportional to the Ct value) to show how it changes over time Measurements of viral RNA indicate that viruses in the digestive system may last longer than viruses in the respiratory tract has reported clinical characteristics of SARS-CoV-2 infection in adults elsewhere However, very few paediatric cases have been published and their clinical characteristics have not been confirmed Ten pediatric patients reported here had lighter clinical symptoms and fewer changes in radiology and laboratory test parameters than adult patients For example, none of the ten patients showed clear clinical signs or chest X-rays consistent with pneumonia Mild and atypical manifestations of infection in children may be difficult to detect , the study also observed real-time RT-PCR positive results for eight rectal swabs in ten children, which were well detected after the nasopharyngeal swab turned negative, indicating possible fecal transmission The findings also suggest that rectal swabs tests may be more useful than nasopharyngeal swabs tests in determining the effectiveness of treatment and determining the timing of quarantine termination