Background:We aimed to identify clinical features of coronavirus disease 2019 (COVID-19) in children and evaluate the role of procalcitonin in early differential diagnosis. Methods: A retrospective analysis was performed on all suspected pediatric cases. Results: 39 (50.6%) of 77 suspected cases were comfirmed, 4 (5.2%) of them had viral coinfection.Compared with non-COVID-19 group (n=33),COVID-19 confirmed group (n=39) had fewer fever(OR[95% CI]0.467[0.314 to 0.694];P=.000) and symptoms of acute respiratory infection (0.533[0.36 to 0.788];P=.001),more asymptomatic (13.568[1.895 to 96.729];P=.000),and more family cluster infections (5.077[2.224 to 11.591];P=.000),while computed tomography had more positive findings of viral pneumonia (1.822[1.143 to 2.906];P=.008).Age(6.9[3.6 to 10.5] vs 5[2.1 to 7.6];P=.088) and gender were statistically insignificant.Procalcitonin (0.05[0.029 to 0.076] vs 0.103[0.053 to 0.21];P=.000) of COVID-19 alone group (n=35) was significantly reduced.While compared with coinfection group (n=4),procalcitonin (0.05[0.029 to 0.076] vs 0.144[0.109 to 2.26];P=.010) was also reduced.The area under curve of model is 0.834 ([95%CI][0.741 to 0.926];P=.000).Procalcitonin as a differential indicator of COVID-19 alone,its area under curve is 0.809 ([0.710 to 0.909];P=.000). The optimal cut-off value is 0.1 ng/mL,the sensitivity, specificity, positive and negative predictive value of differentiating are 65.9%, 78.6%, 82.9%, and 59.2%,respectively. Conclusions: Asymptoms or mild symptoms,positive computed tomography findings and family cluster infection are the main clinical features of COVID-19 in children.With good performance, procalcitonin can provide an important basis for differentiating COVID-19 alone and other viral infection or viral coinfection. Keywords:children;coronavirus disease 2019;differential diagnosis; procalcitonin; suspected

中文翻译：

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降钙素原在可疑儿童COVID-19的早期鉴别诊断中的作用

背景：我们旨在鉴定儿童冠状病毒病2019（COVID-19）的临床特征，并评估降钙素在早期鉴别诊断中的作用。方法：对所有疑似儿科病例进行回顾性分析。结果：确诊的77例疑似病例中有39例（50.6％）确诊为病毒性合并感染，其中4例（5.2％）与非COVID-19组（n = 33）相比，COVID-19确诊组（n = 39）较少发烧（OR [95％CI] 0.467 [0.314至0.694]； P = .000）和急性呼吸道感染症状（0.533 [0.36至0.788]； P = .001），无症状（13.568 [1.895至96.729]） ； P = .000）和更多的家庭簇感染（5.077 [2.224至11.591]； P = .000），而计算机断层扫描对病毒性肺炎的阳性率更高（1.822 [1.143至2.906]； P = .008）。年龄（6.9 [3.6至10.5]对5 [2.1至7.6]； P =。088）和性别无统计学意义。仅COVID-19组（n = 35）降钙素原（0.05 [0.029至0.076]比0.103 [0.053至0.21]； P = .000）显着降低。 n = 4），降钙素（0.05 [0.029至0.076]对0.144 [0.109至2.26]； P = .010）也减少了。模型曲线下面积为0.834（[95％CI] [0.741至0.926]； P = .000）。降钙素原单独作为COVID-19的鉴别指标，其曲线下面积为0.809（[0.710至0.909]； P = .000）。最佳临界值是0.1 ng / mL，区分的敏感性，特异性，阳性和阴性预测值分别为65.9％，78.6％，82.9％和59.2％。结论：无症状或轻度症状，计算机断层扫描阳性和家族簇感染是儿童COVID-19的主要临床特征。降钙素原可为区分单独的COVID-19和其他病毒感染或病毒共感染提供重要依据。关键词：儿童；冠状病毒病； 2019年；鉴别诊断；降钙素原 怀疑的