Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland.
Department of Childrens Infectious Diseases, Medical University of Warsaw, Warsaw, Poland.
Sci Rep. 2022 May 11;12(1):7765. doi: 10.1038/s41598-022-11068-0.
The study aimed to analyse the clinical course of COVID-19 in 300 infants, selected from 1283 children diagnosed with COVID-19 between March and December 2020, registered in the SARSTerPED multicenter database. Most of the infants were registered in October and November 2020. 44% of the group were girls, and 56% were boys. At diagnosis, the most common symptoms were fever in 77% of the children, cough in 40%, catarrh in 37%. Pneumonia associated with COVID-19 was diagnosed in 23% of the children, and gastrointestinal symptoms in 31.3%. In 52% of the infants, elevated levels of D-dimers were observed, and in 40%, elevated levels of IL-6 serum concentration were observed. During the second wave of the pandemic, 6 times more infants were hospitalized, and the children were statistically significantly younger compared to the patients during the first wave (3 months vs 8 months, p < 0.0001 respectively). During the second wave, the infants were hospitalized for longer. COVID-19 in infants usually manifests as a mild gastrointestinal or respiratory infection, but pneumonia is also observed with falls in oxygen saturation, requiring oxygen therapy. Gastrointestinal symptoms are common in infants infected with SARS-CoV-2, and infant appetite disorders may lead to hospitalization. The clinical course of the disease differed significantly between the first and second wave of the pandemic. It seems that infants may play a role in the transmission of SARS-COV-2 infections in households, despite mild or asymptomatic courses; eating disorders in infants should be an indication for COVID-19 testing.
这项研究旨在分析 2020 年 3 月至 12 月期间在 SARSTerPED 多中心数据库中登记的 1283 例确诊为 COVID-19 的儿童中 300 名婴儿的临床病程。大多数婴儿在 2020 年 10 月和 11 月登记。该组中 44%为女孩，56%为男孩。在诊断时，最常见的症状是 77%的儿童发热，40%咳嗽，37%流涕。23%的儿童被诊断为与 COVID-19 相关的肺炎，31.3%的儿童有胃肠道症状。在 52%的婴儿中，观察到 D-二聚体水平升高，在 40%的婴儿中，观察到血清 IL-6 浓度升高。在大流行的第二波中，住院的婴儿增加了 6 倍，与第一波相比，患儿的年龄明显更小（分别为 3 个月和 8 个月，p<0.0001）。在第二波中，婴儿住院时间更长。婴儿的 COVID-19 通常表现为轻度胃肠道或呼吸道感染，但也观察到肺炎，伴有血氧饱和度下降，需要氧疗。胃肠道症状在感染 SARS-CoV-2 的婴儿中很常见，婴儿食欲障碍可能导致住院。疾病的临床病程在大流行的第一波和第二波之间有显著差异。似乎婴儿可能在家庭中传播 SARS-COV-2 感染中发挥作用，尽管病程较轻或无症状；婴儿饮食障碍应作为 COVID-19 检测的指征。
