China has classified the Corona Virus Disease 2019(COVID-19) as a statutory category B infectious disease and managed it according to Category B since January 8, 2023.In view that Omicron variant is currently the main epidemic strain in China, in order to guide the treatment of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection in children with the times, refer to the Diagnosis and Treatment Protocol for Novel Coronavirus Infection (Trial 10 th Edition), Expert Consensus on Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fourth Edition) and the Diagnosis and Treatment Strategy for Pediatric Related Viral Infections.The Expert Consensus on the Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fifth Edition) has been formulated and updated accordingly on related etiology, epidemiology, pathogenic mechanism, clinical manifestations, auxiliary examination, diagnosis and treatment, and added key points for the treatment of COVID-19 related encephalopathy, fulminating myocarditis and other serious complications for clinical reference.

Objective:To investigate the consistency between the results of serum specific antibodies to respiratory viruses and the nucleic acid tests in children with community acquired pneumonia, and to guide clinical application of these tests.Methods:Data of 109 cases of children with community acquired pneumonia diagnosed as viral infection by real-time fluorescence quantitative PCR from nasopharyngeal swab specimens were collected. Their acute and convalescent serum specimens were collected and used to detect common respiratory viruses (respiratory syncytial virus, adenovirus, influenza A virus, influenza B virus and parainfluenza virus) specific IgM antibodies by indirect immunofluorescence method . The consistency between the results of virus serum specific antibody test and respiratory virus nucleic acid test was analyzed.Results:Among the 109 cases of community-acquired pneumonia patients with positive respiratory virus nucleic acid test, 14 cases (12.8%) were positive for virus specific IgM in the acute stage. Combining the results of serum virus specific antibody detection in the acute and convalescent phases, 17 cases (15.6%) were positive for virus specific IgM antibody. Consistency analysis showed that the acute phase serum specific IgM antibody test results of respiratory syncytial virus, adenovirus, influenza A virus, influenza B virus and parainfluenza virus were compared with the nucleic acid test results of respiratory specimens, and Kappa values were -0.033, -0.003, 0.053, -0.024, -0.053, respectively. Compared with the nucleic acid test results of respiratory tract specimens and the total serum specific IgM test results of respiratory syncytial virus, adenovirus, influenza A virus, influenza B virus and parainfluenza virus in the acute and convalescence stages, Kappa values were 0.040, -0.053, 0.065, -0.030 and -0.018, respectively. Kappa values were all less than 0.4, indicating that the consistency of detection results of the two methods is poor.Conclusions:The results of serum virus specific IgM antibody detection in children with community acquired pneumonia are poorly consistent with the results of viral nucleic acid detection in respiratory specimens, suggesting that serum virus specific antibody detection with the immunofluorescence method may not be suitable for the diagnosis of viral pathogens in children’s community acquired pneumonia.

Monkeypox is a zoonotic disease.Previous studies have shown that children are vulnerable to monkeypox and are also at high risk for severe disease or complications.In order to improve pediatricians′ understanding of monkeypox and achieve early detection, early diagnosis, early treatment and early disposal, the committee composed of more than 40 experts in the related fields of infectious diseases, pediatrics, infection control and public health formulate this expert consensus, on the basis of the latest clinical management and infection prevention and control for monkeypox released by the World Health Organization (WHO), the guidelines for diagnosis and treatment of monkeypox (version 2022) issued by National Health Commission of the People′s Republic of China and other relevant documents.During the development of this consensus, multidisciplinary experts have repeatedly demonstrated the etiology, epidemiology, transmission, clinical manifestations, laboratory examinations, diagnosis and differential diagnosis, treatment, discharge criteria, prevention, case management process and key points of prevention and control about monkeypox.

Since December 2019, severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infections have raged globally for more than 2 years.China has always adopted scientific and effective prevention and control measures to achieved some success.However, with the continuous variation of SARS-CoV-2 cases and imported cases from abroad, the prevention and control work has become more difficult and complex.With the variation of the mutant strain, the number of cases in children changed, and some new special symptoms and complications were found, which proposed a new topic for the prevention and treatment of SARS-CoV-2 infection in children in China.Based on the third edition, the present consensus according to the characteristics of the new strain, expounded the etiology, pathology, pathogenesis, and according to the clinical characteristics and experience of children′s cases, and puts forward recommendations on the diagnostic criteria, laboratory examination, treatment, prevention and control of children′s cases for providing reference for further guidance of effective prevention and treatment of SARS-CoV-2 infection in children in China.

At present, severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)infection is still rampant worldwide.As of September 10, 2021, there were about 222 million confirmed cases of corona virus disease 2019(COVID-19)and more than 4.6 million deaths worldwide.With the development of COVID-19 vaccines and the gradual vaccination worldwide, the increasing number of cases in children and unvaccinated young people has drawn attention.According to World Health Organization surveillance data, the proportion of COVID-19 infection cases in children gradually increased, and the proportion of cases in the age groups of under 5 years and 5-14 years increased from 1.0% and 2.5% in January 2020 to 2.0% and 8.7% in July 2021, respectively.At present, billions of adults have been vaccinated with various COVID-19 vaccines worldwide, and their protective effects including reducing infection and transmission, reducing severe disease and hospitalization, and reducing death, as well as high safety have been confirmed.Canada, the United States, Europe and other countries have approved the emergency COVID-19 vaccination in children and adolescents aged 12 to 17 years, and China has also approved the phased vaccination of COVID-19 vaccination in children and adolescents aged 3 to 17 years. For smooth advancement and implementation of COVID-19 vaccination in children, academic institutions, including National Clinical Research Center for Respiratory Diseases, National Center for Children′s Health, and The Society of Pediatrics, Chinese Medical Association organized relevant experts to reach this consensus on COVID-19 vaccination in children.

Severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)infection is still worldwide.As a vulnerable group, severe and dead pediatric cases are also reported.Under this severe epidemic situation, children should be well protected.With the widespread vaccination of SARS-CoV-2 vaccine in adults, the infection rate have decreased.Therefore, SARS-CoV-2 vaccine inoculation for children groups step by step is of great significance to the protection of children and the prevention and control of corona virus disease 2019(COVID-19) as a whole.But the safety of children vaccinated with SARS-CoV-2 vaccine is a main concern of parents.Therefore, in order to ensure the safety of vaccination and the implementation of vaccination work, National Clinical Research Center for Respiratory Diseases, National Center for Children′s Health and the Society of Pediatrics, Chinese Medical Association organized experts to interpret the main issue of parents about SARS-CoV-2 vaccine for children, in order to answer the doubts of parents.

2019 novel coronavirus(2019-nCoV) outbreak is one of the public health emergency of international concern.Since the 2019-nCoV outbreak, China has been adopting strict prevention and control measures, and has achieved remarkable results in the initial stage of prevention and control.However, some imported cases and sporadic regional cases have been found, and even short-term regional epidemics have occurred, indicating that the preventing and control against the epidemic remains grim.With the change of the incidence proportion and the number of cases in children under 18 years old, some new special symptoms and complications have appeared in children patients.In addition, with the occurrence of virus mutation, it has not only attracted attention from all parties, but also proposed a new topic for the prevention and treatment of 2019-nCoV infection in children of China.Based on the second edition, the present consensus further summarizes the clinical characteristics and experience of children′s cases, and puts forward recommendations on the diagnostic criteria, laboratory examination, treatment, prevention and control of children′s cases for providing reference for further guidance of treatment of 2019-nCoV infection in children.

Objective To observe the effects of modifiedDanshen Decoction on spermidine/spermine acetyltransferase (SSAT) /polyamine pathways of SD rats with IRI; To investigate its protective mechanism. Methods The model of IRI was established by ligating left anterior descending coronary artery for 30 min followed by reperfusion for 90 min. The SD rats were randomly divided into the control group, sham-operation group, model group and modifiedDanshen Decoction group, with 10 rats in each group. The myocardial infarction size was measured by using TTC staining. The contents of SSAT were measured by ELISA. The SSAT mRNA and SSAT protein expression level were detected with real-time fluorescent quantitative PCR method and Western blot, respectively. The contents of polyamines (putrescine, spermidine, spermine) in cardiac tissue were detected by HPLC. Results Compared with sham-operation group, the myocardial infarction size, the SSAT content, the SSAT mRNA and SSAT protein expression levels of model group increased significantly, the contents of polyamines decreased significantly, with statistical significance (P<0.01); Compared with model group, the myocardial infarction size of modifiedDanshen Decoction group was significantly reduced, while the SSAT content and SSAT mRNA and protein expression level decreased significantly, the contents of polyamines increased, with statistical significance (P<0.05, P<0.01).ConclusionModifiedDanshen Decoction can adjust the SSAT polyamine pathways and increase polyamine content in cardiomyocytes, and thus play a role of protection of myocardial ischemia-reperfusion injury.

Objective To describe the clinical characteristics of acute lower respiratory tract infection (ALRTI)caused by human coronavirus (HCoV)in children.Methods Three thousand five hundred and three hospi-talized children diagnosed with ALRTI in Beijing Children′s Hospital from March 2007 to February 201 3 were re-viewed.Nasopharyngeal aspirate(NPA)specimen was collected from each patient.Reverse transcription (RT)-poly-merase chain reaction(PCR)methods were applied to detect common respiratory viruses including respiratory syncytial virus (RSV),rhinovirus (RV),parainfluenza virus (PIV)type 1 -4,influenza virus type A and B (IFA,IFB),adeno-virus (AdV),enterovirus (EV),HCoV,human metapneumovirus (hMPV)and human bocavirus (HBoV).Serum anti-bodies of mycoplasma and sputum bacterial culture were also detected.Only HCoV positive patients were analyzed in this study.Results Eleven of 3 503 patients were proved as HCoV -positive in NPA specimens.Of the 1 1 children,8 cases were male and 3 cases were female (2.71 .0).The median age was 3 months.The clinical symptoms of HCoV infection included cough (1 1 /1 1 cases,1 00.0%),wheezing (1 0 /1 1 cases,90.9%),fever (6 /1 1 cases,54.5%)and poor appetite (7 /1 1 cases,63.6%).Wheezing (8 /1 1 cases,72.7%)and moist rale in inspiratory phase (5 /1 1 ca-ses,45.4%)could be heard.Most patient′s chest X -ray showed bronchopneumonia.Full blood count displayed that leukocyte was in the normal range.Conclusions Respiratory tract infection with HCoV -positive will be easier to spread to ALRTI,especially in infants less than 1 year old.The symptoms include fever,cough and wheezing,but poor appetite and diarrhea can also be detected.

OBJECTIVETo investigate human coronaviruses (HCoVs) infection in children with acute lower respiratory tract infection(ALRTI)and to explore the clinical features of ALRTI caused by HCoVs in children.

METHODTotally 4 371 children with clinical diagnosis of ALRTI during the period from March 2007 to February 2015 seen in Beijing Children's Hospital were recruited into this study. Patients were divided into 4 groups by age, including 1 890 cases in < 1 year group, 788 cases in 1-3 years group, 553 cases in 3-6 years group, 1140 cases in ≥6 years group. One nasopharyngeal aspirate specimen was collected from each patient. RT-PCR methods were applied to detect 9 common respiratory viruses including HCoVs (including HCoV-OC43, HCoV-229E, HCoV-NL63 and HCoV-HKU1), respiratory syncytial virus (RSV) and so on. Clinical features of ALRTI with single HCoVs infection were analyzed and compared with hospitalized ALRTI cases with single RSV infection in the same period.

RESULT(1) Totally 2 895 cases were positive for at least one virus in this study in 4 371 ALRTI patients (positive rate 66.23%), in which 147 cases were positive for HCoVs infection (positive rate 3.36%). (2) Positive rates of HCoVs in each year from 2007 to 2014 were 6.11%, 3.79%, 4.69%, 4.31%, 2.38% 2.10%, 0.77% and 2.65%, respectively. The mean positive rates of HCoVs for each month from January to December were 2.53%, 2.12%, 3.63%, 6.68%, 1.53%, 3.77%, 3.92%, 3.00%, 2.15%, 5.26%, 3.01% and 2.80%. (3) Detection results of each subtypes of HCoVs in total 4 371 pediatric ALRTI patients were: 48 cases positive for HCoV-OC43(1.10%), 32 cases positive for HCoV-229E(0.73%), 25 cases positive for HCoV-NL63 (0.57%), 27 cases positive for HCoV-HKU1 (0.62%). (4) Positive rates of HCoVs infection in <1 year group, 1-3 years group, 3-6 years group and ≥ 6 years group were 4.13%, 5.08%, 2.71% and 1.23%, respectively. There were significant differences in positive rates of HCoV among groups (χ² = 27.218, P<0.01). (5) There were 16 hospitalized cases with single infection of HCoVs in this study, of which 12 cases were diagnosed as bronchopneumonia, 3 cases developed acute laryngeal obstruction, 2 cases had acute bronchial asthma attack. Common clinical manifestations included cough (14 cases), gasping (13 cases), dyspnea (9 cases), fever (6 cases), hoarseness (4 cases), laryngeal stridor (4 cases) and abnormality on chest X-ray (including fuzzy lung texture, patchy shadow and consolidation) (12 cases). (6) There were no significant differences in the incidence of clinical manifestations (including cough, gasping, dyspnea, fever and abnormality on chest X-ray), complications (including respiratory failure, myocardial damage, and acute bronchial asthma attack) and mechanical ventilation between hospitalized ALRTI patients with single HCoV infection and 193 patients with single RSV infection in the same period.

CONCLUSIONHCoVs are pathogens of ALRTI in children, The overall positive rate of HCoVs was 3.36% in this study. The clinical manifestations and severity of ALRTI caused by single HCoVs was comparable to that of ALRTI with single RSV infection in children.

Acute Disease ; Beijing ; Child ; Child, Preschool ; Coronavirus ; Coronavirus Infections ; epidemiology ; Humans ; Incidence ; Infant ; Respiratory Syncytial Virus Infections ; epidemiology ; Respiratory Syncytial Viruses ; Respiratory Tract Infections ; epidemiology ; virology