Department of Infectious Disease, Shanghai Children's Medical Center, National Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Dongfang Rd. 1678, Shanghai, 200127, China.
Department of Outpatient and Emergency, Shanghai Children's Medical Center, National Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China.
World J Pediatr. 2023 Jan;19(1):87-95. doi: 10.1007/s12519-022-00621-6. Epub 2022 Oct 17.
The number of pediatric cases of infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant has increased. Here, we describe the clinical characteristics of children in a tertiary children's medical center in Shanghai.
A total of 676 pediatric coronavirus disease 2019 (COVID-19) cases caused by the Omicron variant who were admitted to the Shanghai Children's Medical Center from March 28 to April 30, 2022 were enrolled in this single-center, prospective, observational real-world study. Patient demographics and clinical characteristics, especially COVID-19 vaccine status, were assessed.
Children of all ages appeared susceptible to the SARS-CoV-2 Omicron variant, with no significant difference between sexes. A high SARS-CoV-2 viral load upon admission was associated with leukocytopenia, neutropenia, and thrombocytopenia (P = 0.003, P = 0.021, and P = 0.017, respectively) but not with physical symptoms or radiographic chest abnormalities. Univariable linear regression models indicated that comorbidities (P = 0.001) were associated with a longer time until viral clearance, and increasing age (P < 0.001) and two doses of COVID-19 vaccine (P = 0.001) were associated with a shorter time to viral clearance. Multivariable analysis revealed an independent effect of comorbidities (P < 0.001) and age (P = 0.003). The interaction effect between age and comorbidity showed that the negative association between age and time to virus clearance remained significant only in patients without underlying diseases (P < 0.001).
This study describes the clinical characteristics of children infected with the Omicron variant of SARS-CoV-2 and calls for additional studies to evaluate the effectiveness and safety of vaccination against COVID-19 in children.
感染严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）奥密克戎变异株的儿科病例数量有所增加。在此，我们描述了上海一家三级儿童医院的奥密克戎变异株感染患儿的临床特征。
本研究为单中心、前瞻性、观察性真实世界研究，纳入 2022 年 3 月 28 日至 4 月 30 日期间因奥密克戎变异株感染而入住上海儿童医学中心的 676 例儿童 2019 冠状病毒病（COVID-19）病例。评估了患者的人口统计学特征和临床特征，尤其是 COVID-19 疫苗接种状况。
所有年龄段的儿童似乎都容易感染 SARS-CoV-2 奥密克戎变异株，且男女之间无显著差异。入院时 SARS-CoV-2 病毒载量高与白细胞减少、中性粒细胞减少和血小板减少相关（P = 0.003、P = 0.021 和 P = 0.017），但与体格症状或胸部影像学异常无关。单变量线性回归模型表明，合并症（P = 0.001）与病毒清除时间延长相关，年龄增加（P < 0.001）和接种两剂 COVID-19 疫苗（P = 0.001）与病毒清除时间缩短相关。多变量分析显示，合并症（P < 0.001）和年龄（P = 0.003）有独立影响。年龄与合并症之间的交互作用表明，仅在无基础疾病的患者中，年龄与病毒清除时间之间的负相关仍然显著（P < 0.001）。
本研究描述了感染 SARS-CoV-2 奥密克戎变异株的儿童的临床特征，并呼吁开展更多研究以评估 COVID-19 疫苗在儿童中的有效性和安全性。
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