1Instituto de Medicina Integral Prof. Fernando Figueira, Recife, Brazil.
2Faculdade Pernambucana de Saúde, Recife, Brazil.
Am J Trop Med Hyg. 2021 Feb 18;104(4):1507-1512. doi: 10.4269/ajtmh.20-1368.
COVID-19 in children and adolescents has low frequency, severity, and fatality rate all over the world. A cross-sectional study was conducted to assess the epidemiological and clinical aspects of COVID-19 in patients younger than 20 years in Pernambuco (Brazil), with cases confirmed by reverse-transcriptase-PCR SARS-CoV-2 between 13 February and June 19, 2020, reported on information systems. Data regarding age (< 30 days, 1-11 months, 1-4 years, 5-9 years, 10-14 years, and 15-19 years), gender, color/race, symptoms, pregnancy or puerperium, comorbidities, hospitalization, and death were investigated. Fatality rate and mortality coefficient were calculated, and a multiple logistic regression analysis was performed to determine if gender, age, and comorbidities were factors associated with death. Of 682 pediatric cases, 52.8% were female, with a mean age of 9 ± 7.2 years. The most frequent symptoms were fever (64.4%), cough (52.4%), and respiratory distress (32.4%). Hospitalization was reported in 46.2% of cases, mainly among neonates (80.3%) and infants (73.8%). Thirty-eight deaths were notified, and a fatality rate of 5.6% (95% CI: 3.9-7.3) was found, with higher fatality rates among neonates 11.5% (7 of 61) and 9.5% (8 of 84) infants. The mortality coefficient was 10.9 per 100,000 inhabitants < 1 year of age, whereas comorbidities (Odds ratio [OR] = 14.13, 95% CI: 6.35-31.44), age < 30 days (OR = 5.17, 95% CI: 1.81-14.77), and age 1-11 months (OR = 3.28, 95% CI: 1.21-8.91) were independent factors associated with death. The results demonstrate the vulnerability of neonates and infants with severe conditions, need hospitalization, and high fatality rate, indicating the necessity to adapt public health policies for these age-groups.
儿童和青少年的 COVID-19 发病率低，严重程度和死亡率均较低。本横断面研究评估了巴西伯南布哥州 2020 年 2 月 13 日至 6 月 19 日期间，通过逆转录酶聚合酶链反应 SARS-CoV-2 确诊的 20 岁以下患者的流行病学和临床特征。通过信息系统报告年龄（< 30 天，1-11 个月，1-4 岁，5-9 岁，10-14 岁和 15-19 岁），性别，肤色/种族，症状，妊娠或产褥期，合并症，住院和死亡的病例。计算病死率和死亡率，并进行多因素逻辑回归分析，以确定性别，年龄和合并症是否与死亡相关。在 682 例儿科病例中，52.8％为女性，平均年龄为 9±7.2 岁。最常见的症状是发烧（64.4％），咳嗽（52.4％）和呼吸窘迫（32.4％）。46.2％的病例报告住院治疗，主要是新生儿（80.3％）和婴儿（73.8％）。有 38 人死亡，病死率为 5.6％（95％CI：3.9-7.3），其中新生儿的病死率较高，为 11.5％（61 例中有 7 例）和 9.5％（84 例中有 8 例）。婴儿。每 100,000 名年龄<1 岁的居民中死亡率为 10.9，而合并症（优势比[OR] = 14.13，95％CI：6.35-31.44），年龄<30 天（OR = 5.17，95％CI：1.81-14.77）和年龄 1-11 个月（OR = 3.28，95％CI：1.21-8.91）是死亡的独立危险因素。结果表明，患有严重疾病，需要住院治疗和高病死率的新生儿和婴儿容易受到伤害，这表明有必要为这些年龄组调整公共卫生政策。
