Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, United States of America.
Swedish Cancer Institute, Seattle, WA, United States of America.
PLoS One. 2021 Mar 24;16(3):e0243042. doi: 10.1371/journal.pone.0243042. eCollection 2021.
As the coronavirus (COVID-19) epidemic passed initial infection peak in Washington State, phased re-opening lifted stay-at-home orders and restrictions leading to increased non-essential work, social activities and gathering, especially among younger persons.
A longitudinal cohort analysis of Washington State Department of Health COVID-19 confirmed case age distribution 1) March-April 2020 (N = 13,934) and 2) March-August 2020 (N = 76,032) for proportional change over time using chi square tests for significance.
From March 1st to April 19, 2020 COVID-19 age distribution shifted with a 10% decline in cases age 60 years and older and a 20% increase in age 0-19/20-39 years (chi-square = 223.10, p < .001). Number of cases over the initial analysis period were 0-19 years n = 515, 20-39 years n = 4078, 40-59 years n = 4788, 60-79 years n = 3221, 80+ years n = 1332. After the peak (March 22, 2020), incidence declined in older age groups and increased among age 0-19 and 20-39 age groups from 20% to 40% of total cases by April 19 and 50% by May 3. During this time testing expanded with more testing among older age groups and less testing among younger age groups while case positivity shifted young. Percent positive cases age 0-19/20-39 years through August 2020 increased to a consistent average of 60% [age 0-19 increased to 19% (N = 10257), age 20-39 increased to 42% (N = 30215)].
An increased sustained proportion of COVID-19 incidence is present among children (age 0-19) and young adults (age 20-39) indicating an elevated role in disease spread during the epidemic creating a possible reservoir of disease with spillover risk to more vulnerable older persons and those with comorbid conditions. Media savvy age-appropriate messaging to enhance mitigation compliance among less vulnerable, more mobile and lower priority vaccination age groups will be a continued necessity and priority to reduce overall population incidence.
随着冠状病毒（COVID-19）疫情在华盛顿州度过最初的感染高峰，分阶段重新开放取消了居家令和限制，导致非必要的工作、社交活动和聚会增加，尤其是在年轻人中。
对华盛顿州卫生部 COVID-19 确诊病例年龄分布的纵向队列分析 1）2020 年 3 月至 4 月（N = 13934）和 2）2020 年 3 月至 8 月（N = 76032），使用卡方检验进行时间上的比例变化，以确定显著性。
从 2020 年 3 月 1 日至 4 月 19 日，COVID-19 的年龄分布发生了变化，60 岁及以上年龄段的病例减少了 10%，0-19 岁和 20-39 岁年龄段的病例增加了 20%（卡方=223.10，p<0.001）。在最初的分析期间，0-19 岁的病例数为 515 例，20-39 岁的病例数为 4078 例，40-59 岁的病例数为 4788 例，60-79 岁的病例数为 3221 例，80 岁及以上的病例数为 1332 例。在高峰期（2020 年 3 月 22 日）之后，老年人群体的发病率下降，0-19 岁和 20-39 岁年龄组的发病率从 4 月 19 日的 20%增加到 40%，到 5 月 3 日增加到 50%。在此期间，随着老年人群体检测量的增加和年轻人群体检测量的减少，检测范围扩大，而病例阳性率则向年轻人转移。2020 年 8 月之前，0-19/20-39 岁年龄组的阳性病例百分比增加到 60%（0-19 岁增加到 19%（N=10257），20-39 岁增加到 42%（N=30215））。
儿童（0-19 岁）和青年（20-39 岁）COVID-19 发病率持续增加，表明在疫情期间疾病传播中作用上升，可能成为疾病的潜在蓄水池，并有可能向更脆弱的老年人和患有合并症的人溢出风险。针对不同年龄段的媒体明智的、适合年龄的信息传递，以增强对较不易受感染、更活跃和优先接种疫苗年龄组的缓解措施的遵守，将是减少总体人口发病率的持续必要性和优先事项。
