To explore clinical epidemiological and imaging data of a 2⁺ -month-old infant with corona virus disease 2019 (COVID-19) by imported and familial cluster infection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and review the literatures.

The 2⁺ -month-old infant with COVID-19 who was admitted to the First People′s Hospital of Jintang County, Sichuan Province on February 7, 2020 were selected as the study subject. Clinical data of the infant with COVID-19 were collected by retrospective analysis method, and clinical epidemiological characteristics and imaging data, diagnosis, treatment protocol and prognosis were analyzed. With the keywords of " infant" " 2019 novel coronavirus (2019-nCoV)" " novel coronavirus pneumonia (NCP)" " SARS-CoV-2" and " COVID-19", literatures related with COVID-19 infants were retrieved from PubMed, Medline, China National Knowledge Infrastructure, VIP database, Wanfang Data Knowledge Service Platform, and on public platforms such as the " medical pediatric channel" and news websites. Literatures retrieval time was set from December 1, 2019 to February 21, 2020. Clinical characteristics, diagnosis, treatment protocols and prognosis of COVID-19 infants were summarized. This study was consistent with the requirements of World Medical Association Declaration of Helsinki revised in 2013.

①The results of medical history collection, diagnosis, and treatment of the infant were as follows: infant, male, two months and 29 days old. On January 18, 2020, the infant′s aunt came back from Wuhan the outbreak centre of epidemic to Sichuan Province. After close contact, the infant developed symptoms, such as shortness of breath, slight cough, and diarrhea. The results of the Mycoplasma pneumonia, Chlamydophila pneumonia, influenza A and B virus antigens all were negative after admission. Chest CT examination results showed that multiple subpleural light ground glass opacities were found in both lungs. Two times of nasopharyngeal swabs of SARS-CoV-2 both were positive with RT-PCR test, and the infant was confirmed as COVID-19 based on epidemiological data, clinical manifestations, imaging findings, and RT-PCR test results. Clinical symptoms of shortness of breath and cough disappeared, lung lesions absorbed on chest imaging, and RT-PCR test turned to negative after symptomatic treatment of the infant. Currently, the infant was observed continually and waited for discharge. ②Literatures review results revealed that 5 literatures and 2 news reports about infant COVID-19 in China were retrieved according to the literature search strategy in this study, involving the clinical characteristics, diagnosis, treatments and prognosis of 18 cases of infants with COVID-19. All of the 18 cases showed epidemiological characteristics of imported and familial cluster infection (with a history of contact with Wuhan COVID-19 patient). Among the 18 cases, there were 3 neonates whose mothers were infected with SARS-CoV-2. Among the 3 neonates, 2 cases were effectively quarantined without any contact with infected patients. Initial symptoms of the 18 cases were as follows: fever in 5 cases (27.8%), cough and lower respiratory symptoms in 3 cases (16.7%), sneezing and vomiting milk in 1 case (5.6%), asymptomatic in 3 cases (16.7%), and unknown in 6 cases (33.3%). There were 7 infants with report of chest CT examinations results, and CT images results of them all were abnormal with increased bronchovascular shadows, ground glass opacity, and/or consolidation of bilateral or unilateral lung. Among them, 16 cases had satisfying prognosis except for 2 cases with no prognostic data, and no death was reported.

COVID-19 infants reported in literatures and the infant included in this study all have the characteristics of imported and familial cluster infection characteristics. As for newborn patients, the possibility of vertical transmission from mother to child still cannot be excluded. In addition, clinical symptoms of infant patients are mild, the pulmonary lesions are small and limited, and their prognoses are relatively good. During the outbreak of COVID-19, the protection of children, especially infants should been strengthened, and avoid imported, familial cluster infection of SARS-CoV-2.