Primary Health Care Center "José Ramón Muñoz Fernández", Zaragoza, Spain.
Hospital Materno-Infantil Miguel Servet, Zaragoza, Spain.
Eur J Pediatr. 2022 Mar;181(3):1235-1242. doi: 10.1007/s00431-021-04235-4. Epub 2021 Aug 18.
Most publications on pediatric COVID-19 in Spain were performed at the beginning of the pandemic when some diagnostic tools were not widely available. This study aims to show the real spectrum of the infection based on wide detection of cases due to symptoms and contact tracing. A descriptive and analytical observational study was performed including pediatric cases (0 to 14 years) from the region of Aragón between May 12 and October 31, 2020. Diagnostics was by PCR detection of viral RNA, rapid antigen detection test, or positive IgG serology. There were 5933 positive children included. Of them, 49.03% were women. The mean age was 7.53 ± 4.28 years. The source of infection could not be determined in 17.8% of cases. As for the rest, was determined to be within the family environment in 67.8%. The percentage of asymptomatic patients was 50.3%. Among symptomatic patients, fever (58.1%) and cough (46.7%) were the most frequent symptoms. Hospitalization was required in 0.52% of infected, intensive care unit admission was on 0.05%, and there was one death (0.02%). Children under the age of one presented some symptoms more frequently (71.6% vs 48.5%; OR 2.68; 95% CI 2.08 to 3.45; p < 0.001) and required more hospitalizations (3.9% vs 0.34%; OR 11.52; 95% CI 5.65 to 23.52; p < 0.001).Conclusion: In our environment, SARS-CoV-2 infection is like other mild respiratory viral infections in the population under the age of 15. The contagion occurs mainly in the family environment, the number of asymptomatic is high, being the symptoms mild and the complications very infrequent. What is Known: • Pediatric infection produced by SARS-CoV-2 has manifested as a mild disease in relation to adult age, although with higher affectation at the youngest ages. • Nearly all studies on epidemiology and clinical spectrum of the disease were conducted with patients diagnosed at the beginning of the pandemic. By then, diagnostic tools were only available in hospitals and in emergency units. What is New: • Once diagnostic means were available in primary care medicine and were used not only for the diagnosis of clinical symptoms of the patient, but for the tracing of case contacts, a much more precise approach to the epidemiology and clinical manifestations of the disease was allowed, as described in this study.
大多数关于西班牙儿科 COVID-19 的出版物都是在大流行初期发表的，当时一些诊断工具还没有广泛应用。本研究旨在通过对因症状和接触追踪而发现的大量病例进行广泛检测，展示感染的真实谱。这是一项描述性和分析性观察研究，纳入了 2020 年 5 月 12 日至 10 月 31 日期间阿拉贡地区的儿科病例（0 至 14 岁）。诊断方法是通过病毒 RNA 的 PCR 检测、快速抗原检测或阳性 IgG 血清学检测。共纳入 5933 例阳性儿童。其中，49.03%为女性。平均年龄为 7.53±4.28 岁。无法确定 17.8%病例的感染源。其余病例中，67.8%的感染源确定为家庭环境。无症状患者的比例为 50.3%。在有症状的患者中，发热（58.1%）和咳嗽（46.7%）是最常见的症状。感染后需要住院治疗的患者占 0.52%，入住重症监护病房的患者占 0.05%，有 1 例死亡（0.02%）。1 岁以下儿童更常出现某些症状（71.6%比 48.5%；OR 2.68；95%CI 2.08 至 3.45；p<0.001），需要更多的住院治疗（3.9%比 0.34%；OR 11.52；95%CI 5.65 至 23.52；p<0.001）。结论：在我们的环境中，SARS-CoV-2 感染与 15 岁以下人群中的其他轻度呼吸道病毒感染相似。传染主要发生在家庭环境中，无症状感染者数量较多，症状较轻，并发症非常罕见。已知情况：•SARS-CoV-2 引起的儿科感染在成人中表现为轻度疾病，尽管在最小年龄组中的影响更大。•几乎所有关于该疾病的流行病学和临床谱的研究都是在大流行初期对在医院和急诊部门就诊的患者进行诊断时进行的。此后，诊断工具仅在初级保健医学中可用，不仅用于诊断患者的临床症状，还用于追踪病例接触者，因此可以更准确地了解该疾病的流行病学和临床表现，正如本研究所述。
