科威特儿科队列中 SARS-CoV-2 再感染的发生率。
Incidence of SARS-CoV-2 reinfection in a paediatric cohort in Kuwait.
机构信息
Department of Pediatrics, Farwaniya Hospital, Farwaniya, Kuwait.
Department of Population Health, Dasman Diabetes Institute, Kuwait City, Kuwait.
出版信息
BMJ Open. 2022 Jun 28;12(6):e056371. doi: 10.1136/bmjopen-2021-056371.
OBJECTIVE
Subsequent protection from SARS-CoV-2 infection in paediatrics is not well reported in the literature. We aimed to describe the clinical characteristics and dynamics of SARS-CoV-2 PCR repositivity in children.
DESIGN
This is a population-level retrospective cohort study.
SETTING
Patients were identified through multiple national-level electronic COVID-19 databases that cover all primary, secondary and tertiary centres in Kuwait.
PARTICIPANTS
The study included children 12 years and younger between 28 February 2020 and 6 March 2021. SARS-CoV-2 reinfection was defined as having two or more positive SARS-CoV-2 PCR tests done on a respiratory sample, at least 45 days apart. Clinical data were obtained from the Pediatric COVID-19 Registry in Kuwait.
PRIMARY AND SECONDARY OUTCOME MEASURES
The primary measure is to estimate SARS-CoV-2 PCR repositivity rate. The secondary objective was to establish average duration between first and subsequent SARS-CoV-2 infection. Descriptive statistics were used to present clinical data for each infection episode. Also, incidence-sensitivity analysis was performed to evaluate 60-day and 90-day PCR repositivity intervals.
RESULTS
Thirty paediatric patients with COVID-19 had SARS-CoV-2 reinfection at an incidence of 1.02 (95% CI 0.71 to 1.45) infection per 100 000 person-days and a median time to reinfection of 83 (IQR 62-128.75) days. The incidence of reinfection decreased to 0.78 (95% CI 0.52 to 1.17) and 0.47 (95% CI 0.28 to 0.79) per person-day when the minimum interval between PCR repositivity was increased to 60 and 90 days, respectively. The mean age of reinfected subjects was 8.5 (IQR 3.7-10.3) years and the majority (70%) were girls. Most children (55.2%) had asymptomatic reinfection. Fever was the most common presentation in symptomatic patients. One immunocompromised experienced two reinfection episodes.
CONCLUSION
SARS-CoV-2 reinfection is uncommon in children. Previous confirmed COVID-19 in children seems to result in a milder reinfection.
目的
小儿科中，关于 SARS-CoV-2 感染的后续保护在文献中报道较少。本研究旨在描述儿童的 SARS-CoV-2 PCR 复阳率的临床特征和动态变化。
设计
这是一项基于人群的回顾性队列研究。
地点
通过覆盖科威特所有初级、中级和高级医疗中心的多个国家级电子 COVID-19 数据库来识别患者。
参与者
本研究纳入 2020 年 2 月 28 日至 2021 年 3 月 6 日期间年龄在 12 岁及以下的儿童。SARS-CoV-2 再感染定义为至少相隔 45 天两次或以上呼吸道样本 SARS-CoV-2 PCR 检测呈阳性。临床数据来自科威特儿科 COVID-19 登记处。
主要和次要结果
主要测量指标是估计 SARS-CoV-2 PCR 复阳率。次要目标是确定首次和后续 SARS-CoV-2 感染之间的平均时间间隔。采用描述性统计方法对每一次感染的临床数据进行呈现。此外，还进行了发病率敏感性分析，以评估 60 天和 90 天的 PCR 复阳间隔。
结果
30 例 COVID-19 患儿发生 SARS-CoV-2 再感染，发病率为 1.02（95%可信区间为 0.71 至 1.45）/100000 人日，再感染中位时间为 83（IQR 62-128.75）天。当 PCR 复阳的最小间隔分别增加至 60 天和 90 天时，再感染的发病率分别降至 0.78（95%可信区间为 0.52 至 1.17）和 0.47（95%可信区间为 0.28 至 0.79）/人日。再感染患儿的平均年龄为 8.5（IQR 3.7-10.3）岁，大多数（70%）为女孩。大多数患儿（55.2%）无症状再感染。发热是有症状患儿中最常见的表现。1 例免疫功能低下者发生 2 次再感染。
结论
SARS-CoV-2 再感染在儿童中并不常见。既往确诊的 COVID-19 似乎会导致儿童再次感染时病情较轻。
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