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[香港输入儿童新型冠状病毒奥密克戎变异株感染特征]

[Characteristics of SARS-CoV-2 Omicron infection in children imported from Hong Kong].

作者信息

Ma W J, Wang X S, Tian H, Zhu Y F, Wei Z Q, Xu J, Zhu Q R, Zeng M

机构信息

Department of Infectious Disease, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China.

出版信息

Zhonghua Er Ke Za Zhi. 2022 Jun 2;60(6):539-544. doi: 10.3760/cma.j.cn112140-20220423-00367.

DOI:10.3760/cma.j.cn112140-20220423-00367
PMID:35658359
Abstract

To understand the clinical characteristics of children with SARS-CoV-2 Omicron infection imported from Hong Kong Special Administrative Region. This retrospective study was conducted to collect the data including clinical manifestations, outcomes and vaccination of 107 children with SARS-CoV-2 Omicron infection imported from Hong Kong Special Administrative Region to be admitted to the designated referral hospital in Shanghai from February to March 2022. According to the occurrence of clinical symptoms, the cases were divided into asymptomatic group and symptomatic group. According to the age of diagnosis, the cases were divided into <3 years group, 3-<6 years group and 6-<18 years group, and the clinical manifestations in different age group were analyzed with -test and Mann-Whitney rank-sum test. Besides, to analyze the effectiveness of vaccination against SARS-CoV-2 Omicron infection in different age group, the cases aged 3-<18 years were also subdivided into unvaccinated group, 1-dose group and 2-dose group, and the relative risk () was used to demonstrate the effectiveness. Among the 107 cases, 66 were male and 41 were female, with infection age of 10 (5, 14) years. There were 29 cases in the asymptomatic group, and 78 cases in the symptomatic group, and no significant difference in the age of infection was observed between the 2 groups (11 (6, 14) . 10 (5, 14) years, 0.49, >0.05). And there were no severe cases in symptomatic group. The length of hospitalization was (18±6) days, and was longer in symptomatic group than that in asymptomatic group ((19±6) . (16±7) d, 0.17, 0.030). Eight-two cases (76.6%) had a history of epidemiological exposure and, among whom, 81 cases (75.7%) were associated with household transmission. Among symptomatic group, 57 cases (73.1%) had fever and 20 cases (25.6%) had cough. Of the 74 cases undergoing chest CT examination, 17 cases (23.0%) showed mild abnormalities. Of the 83 cases who received the lab tests, 23 cases (27.7%) had white blood cell counts<4×10/L, 3 cases (3.6%) had C-reaction protein >8.0 mg/L, and 6 cases (7.2%) had slightly elevated aspartate transaminase and alanine aminotransferase. Among the 92 children aged 3-<18 years, 31 cases were unvaccinated, 34 cases received 1 dose, and 27 cases received 2 doses. The interval between the last vaccination and infection was 2.2 (0.6, 6.0) months; the interval between the last vaccination and infection in the 2-dose group was longer than that in 1-dose group (6.0 (4.5, 7.3) . 0.7 (0.3,2.0) months, 3.59, 0.001).The risk of symptomatic infection was reduced by 45% 0.55, 95% 0.35-0.87) with two-dose vaccination compared to non-vaccination in cases aged 3-<18 years. All these cases recovered completely. Children infected with SARS-CoV-2 Omicron are usually mild or asymptomatic. Household transmission is the main pattern of infection with SARS-CoV-2 Omicron in children. Two-dose SARS-CoV-2 vaccination in children aged 3-<18 years can provide partial protection against disease caused by SARS-CoV-2 Omicron.

摘要

了解自香港特别行政区输入的新型冠状病毒奥密克戎变异株感染儿童的临床特征。本回顾性研究收集了2022年2月至3月间收治于上海指定定点医院的107例自香港特别行政区输入的新型冠状病毒奥密克戎变异株感染儿童的临床表现、转归及疫苗接种情况。根据临床症状的出现情况,将病例分为无症状组和有症状组。根据确诊年龄,将病例分为<3岁组、3 - <6岁组和6 - <18岁组,采用t检验和Mann-Whitney秩和检验分析不同年龄组的临床表现。此外,为分析不同年龄组接种新型冠状病毒疫苗对奥密克戎变异株感染的有效性,将3 - <18岁的病例进一步细分为未接种组、接种1剂组和接种2剂组,采用相对危险度(RR)来评估有效性。107例病例中,男66例,女41例,感染年龄为10(5,14)岁。无症状组29例,有症状组78例,两组感染年龄差异无统计学意义(11(6,14). 10(5,14)岁,P = 0.49,>0.05)。有症状组无重症病例。住院时间为(18±6)天,有症状组长于无症状组((19±6).(16±7)天,P = 0.17,P<0.030)。82例(76.6%)有流行病学暴露史,其中81例(75.7%)与家庭传播有关。有症状组中,57例(73.1%)发热,20例(25.6%)咳嗽。74例行胸部CT检查的病例中,17例(23.0%)表现为轻度异常。83例行实验室检查的病例中,23例(27.7%)白细胞计数<4×10⁹/L,3例(3.6%)C反应蛋白>8.0mg/L,6例(7.2%)天门冬氨酸氨基转移酶和丙氨酸氨基转移酶轻度升高。92例3 - <18岁儿童中,未接种31例,接种1剂34例,接种2剂27例。最后一剂疫苗接种至感染的间隔时间为2.2(0.6,6.0)个月;接种2剂组最后一剂疫苗接种至感染的间隔时间长于接种1剂组(6.0(4.5,7.3). 0.7(0.3,2.0)个月,P = 3.59,P<0.001)。3 - <18岁病例中,接种2剂疫苗与未接种相比,有症状感染风险降低45%(RR = 0.55,95%CI 0.35 - 0.87)。所有病例均完全康复。新型冠状病毒奥密克戎变异株感染儿童通常症状较轻或无症状。家庭传播是儿童感染新型冠状病毒奥密克戎变异株的主要方式。3 - <18岁儿童接种2剂新型冠状病毒疫苗可对奥密克戎变异株所致疾病提供部分保护。

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