英格兰聚合酶链反应（PCR）确诊的严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染患儿与核酸检测阴性患儿的急性和持续性症状：主动、前瞻性、全国性监测。

Acute and Persistent Symptoms in Children With Polymerase Chain Reaction (PCR)-Confirmed Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection Compared With Test-Negative Children in England: Active, Prospective, National Surveillance.

机构信息

Public Health England, London, United Kingdom.

Paediatric Infectious Diseases Research Group, St. George's University of London, London, United Kingdom.

出版信息

Clin Infect Dis. 2022 Aug 24;75(1):e191-e200. doi: 10.1093/cid/ciab991.

DOI:10.1093/cid/ciab991

PMID:34849658

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8767867/

Abstract

BACKGROUND

Most children recover quickly after coronavirus disease 2019 (COVID-19), but some may have ongoing symptoms. Follow-up studies have been limited by small sample sizes and lack of appropriate controls.

METHODS

We used national testing data to identify children aged 2-16 years with a SARS-CoV-2 PCR test during 1-7 January 2021 and randomly selected 1500 PCR-positive cases and 1500 matched PCR-negative controls. Parents were asked to complete a questionnaire about the acute illness and prespecified neurological, dermatological, sensory, respiratory, cardiovascular, gastrointestinal, mental health (including emotional and behavioral well-being), and other symptoms experienced ≥5 times at 1 month after the PCR test.

RESULTS

Overall, 35.0% (859/2456) completed the questionnaire, including 38.0% (472/1242) of cases and 32% (387/1214) of controls, of whom 68% (320/472) and 40% (154/387) were symptomatic, respectively. The most prevalent acute symptoms were cough (249/859, 29.0%), fever (236/859, 27.5%), headache (236/859, 27.4%), and fatigue (231/859, 26.9%). One month later, 21/320 (6.7%) of symptomatic cases and 6/154 (4.2%) of symptomatic controls (P = .24) experienced ongoing symptoms. Of the 65 ongoing symptoms solicited, 3 clusters were significantly (P < .05) more common, albeit at low prevalence, among symptomatic cases (3-7%) than symptomatic controls (0-3%): neurological, sensory, and emotional and behavioral well-being. Mental health symptoms were reported by all groups but more frequently among symptomatic cases than symptomatic controls or asymptomatic children.

CONCLUSIONS

Children with symptomatic COVID-19 had a slightly higher prevalence of ongoing symptoms than symptomatic controls, and not as high as previously reported. Healthcare resources should be prioritized to support the mental health of children.

摘要

背景

大多数儿童在感染 2019 冠状病毒病（COVID-19）后会迅速康复，但有些儿童可能会持续出现症状。后续研究受到样本量小和缺乏适当对照的限制。

方法

我们利用全国性的检测数据，确定了在 2021 年 1 月 1 日至 7 日期间接受 SARS-CoV-2 PCR 检测的 2 至 16 岁儿童，并随机选择了 1500 例 PCR 阳性病例和 1500 例匹配的 PCR 阴性对照。家长被要求在 PCR 检测后 1 个月填写一份问卷，内容是关于急性疾病以及预先指定的神经系统、皮肤、感觉、呼吸、心血管、胃肠道、心理健康（包括情绪和行为健康）和其他症状，症状≥5 次即可诊断。

结果

总体而言，35.0%（859/2456）完成了问卷，包括病例的 38.0%（472/1242）和对照的 32%（387/1214），其中 68%（320/472）和 40%（154/387）有症状。最常见的急性症状是咳嗽（249/859，29.0%）、发热（236/859，27.5%）、头痛（236/859，27.4%）和疲劳（231/859，26.9%）。一个月后，21/320（6.7%）有症状的病例和 6/154（4.2%）有症状的对照（P=0.24）出现持续症状。在 65 个征集到的持续症状中，3 个症状簇在有症状的病例中（3-7%）显著更常见（P<0.05），尽管在有症状的对照中（0-3%）也有出现：神经系统、感觉和情绪与行为健康。心理健康症状在所有组中均有报告，但在有症状的病例中比有症状的对照或无症状儿童更常见。