Children's National Hospital, Washington, DC; Department of Pediatrics, George Washington University, Washington, DC.
Children's National Hospital, Washington, DC; Department of Pediatrics, George Washington University, Washington, DC.
J Pediatr. 2021 Apr;231:157-161.e1. doi: 10.1016/j.jpeds.2020.12.030. Epub 2020 Dec 22.
To describe the demographics, clinical features, and test results of children referred from their primary provider for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in the community setting.
Retrospective cross-sectional study of children ≤22 years of age who were tested for SARS-CoV-2 at a community-based specimen collection site in Washington, DC, affiliated with a large children's hospital between March 21 and May 16, 2020.
Of the 1445 patients tested at the specimen collection site for SARS-CoV-2 virus, 408 (28.2%) had a positive polymerase chain reaction test. The daily positivity rate increased over the study period, from 5.4% during the first week to a peak of 47.4% (P < .001). Patients with fever (aOR, 1.7; 95% CI, 1.3-2.3) or cough (aOR, 1.4; 95% CI, 1.1-1.9) and those with known contact with someone with confirmed SARS-CoV-2 infection (aOR, 1.6; 95% CI, 1.0-2.4.) were more likely have a positive test, but these features were not highly discriminating.
In this cohort of mildly symptomatic or well children and adolescents referred to a community drive-through/walk-up SARS-CoV-2 testing site because of risk of exposure or clinical illness, 1 in 4 patients had a positive test. Children and young adults represent a considerable burden of SARS-CoV-2 infection. Assessment of their role in transmission is essential to implementing appropriate control measures.
描述在社区环境中，因接触或临床疾病风险而由初级保健医生转诊至社区检测点的儿童中，严重急性呼吸综合征冠状病毒 2 型（SARS-CoV-2）的人口统计学、临床特征和检测结果。
这是一项在华盛顿特区一个与大型儿童医院有关联的社区样本采集点进行的回顾性横断面研究，研究对象为 2020 年 3 月 21 日至 5 月 16 日期间在该采集点接受 SARS-CoV-2 检测的年龄≤22 岁的儿童。
在该社区样本采集点进行的 SARS-CoV-2 病毒检测中，有 1445 名患者，其中 408 名（28.2%）的聚合酶链反应检测结果呈阳性。在研究期间，每日阳性检出率逐渐升高，从第一周的 5.4%上升至峰值 47.4%（P<0.001）。有发热（优势比，1.7；95%置信区间，1.3-2.3）或咳嗽（优势比，1.4；95%置信区间，1.1-1.9）症状的患者以及已知与确诊 SARS-CoV-2 感染患者有接触的患者（优势比，1.6；95%置信区间，1.0-2.4）更有可能检测结果呈阳性，但这些特征的区分能力并不强。
在本研究中，有 1/4 的患者在社区内进行 SARS-CoV-2 检测，这些患者的症状较轻或无症状，且因接触或临床疾病风险而被转诊至检测点，这些患者中，408 名（28.2%）的聚合酶链反应检测结果呈阳性。儿童和青少年是 SARS-CoV-2 感染的主要群体。评估他们在传播中的作用对于实施适当的控制措施至关重要。
