Lugo-Zamudio Gustavo Esteban, Aguilar-Rojas Antonio, Vázquez-Medina Martín Uriel, Gutiérrez-Ramírez Antonio, Upton-Alvarado Ma Cristina, Espinoza-Rivas Patricia, Lagunas-Torres Gustavo, Rojo-Gutiérrez María Isabel, Ibáñez-Cervantes Gabriela, Vargas-De-León Cruz
Dirección General, Hospital Juárez de México, Ciudad de México, Mexico.
Unidad de Vigilancia Epidemiológica Hospitalaria, Hospital Juárez de México, Ciudad de México, Mexico.
Can J Infect Dis Med Microbiol. 2022 Apr 25;2022:6780575. doi: 10.1155/2022/6780575. eCollection 2022.
Evidence from across the world suggests that the pediatric population shows different clinical manifestations and has a lower risk of severe presentation of SARS-CoV-2 infection compared to adults. However, Mexico has one of the highest mortality rates in the pediatric population due to SARS-CoV-2 infection. Therefore, our objective was to explore the epidemiological and clinical characteristics associated with a positive confirmatory test in the Mexican pediatric population admitted to a tertiary care hospital in Mexico City.
Clinical, imaging and laboratory data were retrospectively collected from 121 children hospitalized during the period from March 4, 2020, to August 8, 2021. The patients were identified as suspicious cases according to the guidelines of the General Directorate of Epidemiology of Mexico. Real-time polymerase chain reaction (RT-PCR) tests were used to confirm SARS-CoV-2 infection. Categorical variables were compared using the Chi-square test, and propensity score matching was performed to determine univariate and multivariate odds ratios of the population regarding a positive vs. negative SARS-CoV-2 result.
Of the 121 children, 36 had laboratory-confirmed SARS-CoV-2 infection. The main risk for SARS-CoV-2-associated pediatric hospitalization was contact with a family member with SARS-CoV-2. It was also found that fever and fatigue were statistically significantly associated with a positive SARS-CoV-2 test in multivariate models. Clinical and laboratory data in this Mexican hospitalized pediatric cohort differ from other reports worldwide; the mortality rate (1.6%) of the population studied was higher than that seen in reports from other countries.
Our study found that fever and fatigue at hospital presentation as well as an antecedent exposure to a family member with SARS-CoV-2 infection were important risk factors for SARS-CoV-2 positivity in children at hospital admission.
来自世界各地的证据表明,与成年人相比,儿科人群表现出不同的临床表现,且感染SARS-CoV-2后出现严重症状的风险较低。然而,墨西哥是儿科人群因SARS-CoV-2感染导致死亡率最高的国家之一。因此,我们的目的是探讨墨西哥城一家三级护理医院收治的墨西哥儿科人群中,与确诊试验阳性相关的流行病学和临床特征。
回顾性收集了2020年3月4日至2021年8月8日期间住院的121名儿童的临床、影像学和实验室数据。根据墨西哥流行病学总局的指南,将这些患者确定为可疑病例。采用实时聚合酶链反应(RT-PCR)检测来确诊SARS-CoV-2感染。使用卡方检验比较分类变量,并进行倾向得分匹配以确定人群中SARS-CoV-2检测结果为阳性与阴性的单因素和多因素比值比。
在这121名儿童中,36名实验室确诊感染SARS-CoV-2。与SARS-CoV-2相关的儿科住院的主要风险是与感染SARS-CoV-2的家庭成员接触。还发现,在多变量模型中,发热和疲劳与SARS-CoV-2检测阳性在统计学上显著相关。这个墨西哥住院儿科队列的临床和实验室数据与世界其他报告不同;所研究人群的死亡率(1.6%)高于其他国家的报告。
我们的研究发现,入院时发热和疲劳以及之前接触过感染SARS-CoV-2的家庭成员是儿童入院时SARS-CoV-2检测呈阳性的重要危险因素。