Department of Pediatrics, BC Children's Hospital, Vancouver, BC, Canada; Division of Gastroenterology, Hepatology and Nutrition, BC Children's Hospital, Vancouver, BC, Canada; BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada; Department of Immunology, University of Toronto, Toronto, ON, Canada.
Department of Pediatrics, BC Children's Hospital, Vancouver, BC, Canada; Division of Gastroenterology, Hepatology and Nutrition, BC Children's Hospital, Vancouver, BC, Canada; BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada.
Int J Infect Dis. 2021 Feb;103:246-256. doi: 10.1016/j.ijid.2020.11.163. Epub 2020 Nov 20.
There is limited information on the severity of COVID-19 infection in children with comorbidities. We investigated the effects of pediatric comorbidities on COVID-19 severity by means of a systematic review and meta-analysis of published literature.
PubMed, Embase, and Medline databases were searched for publications on pediatric COVID-19 infections published January 1 to October 5, 2020. Articles describing at least one child with and without comorbidities, COVID-19 infection, and reported outcomes were included.
42 studies containing 275,661 children without comorbidities and 9,353 children with comorbidities were included. Severe COVID-19 was present in 5.1% of children with comorbidities, and in 0.2% without comorbidities. Random-effects analysis revealed a higher risk of severe COVID-19 among children with comorbidities than for healthy children; relative risk ratio 1.79 (95% CI 1.27 - 2.51; I = 94%). Children with underlying conditions also had a higher risk of COVID-19-associated mortality; relative risk ratio 2.81 (95% CI 1.31 - 6.02; I = 82%). Children with obesity had a relative risk ratio of 2.87 (95% CI 1.16 - 7.07; I = 36%).
Children with comorbidities have a higher risk of severe COVID-19 and associated mortality than children without underlying disease. Additional studies are required to further evaluate this relationship.
关于合并症儿童 COVID-19 感染严重程度的信息有限。我们通过对已发表文献的系统评价和荟萃分析，研究了儿科合并症对 COVID-19 严重程度的影响。
检索了 2020 年 1 月 1 日至 10 月 5 日期间发表的关于儿科 COVID-19 感染的 PubMed、Embase 和 Medline 数据库文献。纳入了至少描述了 1 例合并症和 1 例无合并症儿童 COVID-19 感染并报告了结局的研究。
纳入了 42 项研究，共包含 275661 例无合并症儿童和 9353 例合并症儿童。合并症儿童中严重 COVID-19 的发生率为 5.1%，无合并症儿童中为 0.2%。随机效应分析显示，合并症儿童发生严重 COVID-19 的风险高于健康儿童，相对风险比为 1.79（95%CI 1.27-2.51；I = 94%）。患有基础疾病的儿童也有更高的 COVID-19 相关死亡率，相对风险比为 2.81（95%CI 1.31-6.02；I = 82%）。肥胖儿童的相对风险比为 2.87（95%CI 1.16-7.07；I = 36%）。
与无基础疾病的儿童相比，合并症儿童发生严重 COVID-19 和相关死亡的风险更高。需要进一步研究来进一步评估这种关系。
