EPI Task-Force FMUL, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
Unidade de Saúde Pública Francisco George, Lisboa, Portugal.
BMJ Paediatr Open. 2022 Aug;6(1). doi: 10.1136/bmjpo-2022-001499.
COVID-19 is considered by WHO a pandemic with public health emergency repercussions. Children often develop a mild disease with good prognosis and the recognition of children at risk is essential to successfully manage paediatric COVID-19. Quality epidemiological surveillance data are required to characterise and assess the pandemic.
Data on all reported paediatric COVID-19 cases, in Portugal, were retrospectively assessed from a fully anonymised dataset provided by the Directorate General for Health (DGS). Paediatric hospital admission results were obtained from the DGS vaccine recommendations and paediatric intensive care unit (PICU) admission results from the EPICENTRE.PT group. Reported cases and PICU admissions from March 2020 to February 2021 and hospital admissions between March and December 2020 were analysed.
92 051 COVID-19 cases were studied, 50.5% males, average age of 10.1 years, corresponding to 5.4% of children in Portugal. The most common symptoms were cough and fever, whereas gastrointestinal symptoms were infrequent. The most common comorbidity was asthma. A high rate of missing surveillance data was noticed, on presentation of disease and comorbidity variables, which warrants a cautious interpretation of results. Hospital admission was required in 0.93% of cases and PICU on 3.48 per 10 000 cases. PICU admission for Multisystem Inflammatory Syndrome in Children (MIS-C) was more frequent in children with no comorbidities and males, severe COVID-19 was rarer and occurred mainly in females and infants. Case fatality rate and mortality rates were low, 1.8 per 100 000 cases and 1.2 per 1 000 000 cases, respectively.
The overall reported case incidence was 5.4 per 100 children and adolescents and <1% of cases required hospital admission. MIS-C was more frequent in patients with no comorbidities and males. Mortality and case fatality rates were low. Geographic adapted strategies, and information systems to facilitate surveillance are required to improve surveillance data quality.
世界卫生组织（WHO）认为 COVID-19 是一种具有公共卫生紧急影响的大流行病。儿童通常患有预后良好的轻症疾病，识别高危儿童对于成功管理儿科 COVID-19 至关重要。需要高质量的流行病学监测数据来描述和评估大流行。
从葡萄牙卫生总局（DGS）提供的完全匿名数据集回顾性评估了所有报告的儿科 COVID-19 病例的数据。儿科住院结果来自 DGS 的疫苗建议，儿科重症监护病房（PICU）入院结果来自 EPICENTRE.PT 组。分析了 2020 年 3 月至 2021 年 2 月期间的报告病例和 PICU 入院以及 2020 年 3 月至 12 月期间的住院病例。
研究了 92051 例 COVID-19 病例，男性占 50.5%，平均年龄为 10.1 岁，占葡萄牙儿童的 5.4%。最常见的症状是咳嗽和发热，而胃肠道症状不常见。最常见的合并症是哮喘。在疾病和合并症变量出现时，注意到监测数据的高缺失率，这需要谨慎解释结果。病例中有 0.93%需要住院治疗，每 10000 例中有 3.48 例需要进入 PICU。无合并症和男性儿童中多系统炎症综合征（MIS-C）的 PICU 入院更为常见，重症 COVID-19 较少见，主要发生在女性和婴儿中。病死率和死亡率均较低，分别为每 100000 例 1.8 例和每 1000000 例 1.2 例。
总体报告的病例发病率为每 100 名儿童和青少年 5.4 例，不到 1%的病例需要住院治疗。无合并症和男性患者中 MIS-C 更为常见。死亡率和病死率均较低。需要制定适合地理情况的策略和信息系统，以提高监测数据的质量。
