Population, Policy & Practice Research and Teaching Department, University College London Great Ormond Street Institute of Child Health, London, UK
Population, Policy & Practice Research and Teaching Department, University College London Great Ormond Street Institute of Child Health, London, UK.
BMJ Paediatr Open. 2022 Aug;6(1). doi: 10.1136/bmjpo-2022-001545.
There have been no population-based studies of SARS-CoV-2 testing, PCR-confirmed infections and COVID-19-related hospital admissions across the full paediatric age range. We examine the epidemiology of SARS-CoV-2 in children and young people (CYP) aged <23 years.
We used a birth cohort of all children born in Scotland since 1997, constructed via linkage between vital statistics, hospital records and SARS-CoV-2 surveillance data. We calculated risks of tests and PCR-confirmed infections per 1000 CYP-years between August and December 2020, and COVID-19-related hospital admissions per 100 000 CYP-years between February and December 2020. We used Poisson and Cox proportional hazards regression models to determine risk factors.
Among the 1 226 855 CYP in the cohort, there were 378 402 tests (a rate of 770.8/1000 CYP-years (95% CI 768.4 to 773.3)), 19 005 PCR-confirmed infections (179.4/1000 CYP-years (176.9 to 182.0)) and 346 admissions (29.4/100 000 CYP-years (26.3 to 32.8)). Infants had the highest COVID-19-related admission rates. The presence of chronic conditions, particularly multiple types of conditions, was strongly associated with COVID-19-related admissions across all ages. Overall, 49% of admitted CYP had at least one chronic condition recorded.
Infants and CYP with chronic conditions are at highest risk of admission with COVID-19. Half of admitted CYP had chronic conditions. Studies examining COVID-19 vaccine effectiveness among children with chronic conditions and whether maternal vaccine during pregnancy prevents COVID-19 admissions in infants are urgently needed.
目前尚无针对全年龄段儿科人群的 SARS-CoV-2 检测、经 PCR 确认的感染以及 COVID-19 相关住院治疗的基于人群的研究。我们研究了年龄<23 岁的儿童和青少年（CYP）中 SARS-CoV-2 的流行病学。
我们使用了自 1997 年以来苏格兰所有出生儿童的出生队列，通过生命统计数据、医院记录和 SARS-CoV-2 监测数据的链接构建该队列。我们计算了 2020 年 8 月至 12 月期间每 1000 CYP 年的检测和经 PCR 确认的感染率，以及 2020 年 2 月至 12 月期间每 100000 CYP 年的 COVID-19 相关住院率。我们使用泊松和 Cox 比例风险回归模型来确定危险因素。
在队列中的 1226855 名 CYP 中，进行了 378402 次检测（检出率为 770.8/1000 CYP 年（95%CI768.4 至 773.3）），19005 次经 PCR 确认的感染（179.4/1000 CYP 年（176.9 至 182.0））和 346 次住院治疗（29.4/100000 CYP 年（26.3 至 32.8））。婴儿的 COVID-19 相关住院率最高。患有慢性疾病，尤其是多种类型的疾病，与所有年龄段的 COVID-19 相关住院治疗均密切相关。总体而言，49%的住院 CYP 至少有一个慢性疾病记录。
婴儿和患有慢性疾病的 CYP 发生 COVID-19 住院治疗的风险最高。一半的住院 CYP 患有慢性疾病。目前迫切需要研究慢性疾病儿童的 COVID-19 疫苗有效性以及母亲在怀孕期间接种疫苗是否能预防婴儿的 COVID-19 住院治疗。
