儿童 COVID-19：流行病学、临床特征和 RT-qPCR 循环阈值之间的相关性。
COVID-19 in Children: Correlation Between Epidemiologic, Clinical Characteristics, and RT-qPCR Cycle Threshold Values.
机构信息
From the Epidemiology, Ricardo Gutiérrez Children's Hospital, Buenos Aires, Argentina.
Virology, Ricardo Gutiérrez Children's Hospital, Buenos Aires, Argentina.
出版信息
Pediatr Infect Dis J. 2022 Aug 1;41(8):666-670. doi: 10.1097/INF.0000000000003564. Epub 2022 Jul 13.
BACKGROUND
Initially, the impact of SARS-CoV-2 infection on children was unknown. Standard COVID-19 diagnosis is confirmed using real-time qPCR. Cycle threshold (Ct) values of RT-qPCR are inversely proportional to viral load and the test indirectly quantifies viral RNA copy numbers. The objective of this study was to determine the correlation between epidemiology, clinical characteristics, severity of confirmed COVID-19 cases, and Ct values.
METHODS
An observational, analytical, cross-sectional study. All children with COVID-19 under 18 years old admitted to the Ricardo Gutiérrez Children's Hospital between March 1, 2020, and February 28, 2021, were included. SARS-CoV-2 infection was confirmed using RT-qPCR.
RESULTS
Median age of patients was 7 years. Ct values were estimated in 419 cases, median Ct value was 23.5 [interquartile range (IQR): 18.9-30.9]. Levels were significantly lower in symptomatic than asymptomatic patients (Ct: 22.1; IQR: 18.4-22.1), in children <2 years of age (Ct: 20.6; IQR: 17.3-27.3) and when sample collection was <4 days after symptom onset (Ct: 21.1; IQR: 18.1-27.5). In children >2 years of age, Ct values were significantly lower in symptomatic (Ct: 22.6; IQR: 18.7-29.3) than asymptomatic (Ct: 31.2; IQR: 24.5-33.3) patients.
CONCLUSIONS
Children younger than 2 years with COVID-19 have lower values of Ct-as a proxy for higher viral load-than older children. Symptomatic children over 2 years of age had lower Ct values compared with asymptomatic children.
背景
最初，SARS-CoV-2 感染对儿童的影响尚不清楚。标准的 COVID-19 诊断是通过实时 qPCR 确认的。RT-qPCR 的循环阈值（Ct）值与病毒载量成反比，该测试间接定量病毒 RNA 拷贝数。本研究的目的是确定流行病学、临床特征、确诊 COVID-19 病例的严重程度与 Ct 值之间的相关性。
方法
这是一项观察性、分析性、横断面研究。纳入 2020 年 3 月 1 日至 2021 年 2 月 28 日期间入住 Ricardo Gutiérrez 儿童医院的所有 18 岁以下 COVID-19 患儿。使用 RT-qPCR 确认 SARS-CoV-2 感染。
结果
患者的中位年龄为 7 岁。在 419 例病例中估算了 Ct 值，中位 Ct 值为 23.5[四分位距（IQR）：18.9-30.9]。有症状患者的 Ct 值明显低于无症状患者（Ct：22.1；IQR：18.4-22.1），2 岁以下儿童（Ct：20.6；IQR：17.3-27.3）和症状出现后<4 天采集样本（Ct：21.1；IQR：18.1-27.5）。2 岁以上儿童中，有症状患者（Ct：22.6；IQR：18.7-29.3）的 Ct 值明显低于无症状患者（Ct：31.2；IQR：24.5-33.3）。
结论
COVID-19 患儿中，2 岁以下儿童的 Ct 值较低-表示病毒载量较高-比年龄较大的儿童。2 岁以上有症状儿童的 Ct 值低于无症状儿童。
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