Smith Hana, Mahon Allison, Moss Angela, Rao Suchitra
Department of Pediatrics, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado, USA.
Adult and Child Center for Health Outcomes Research and Delivery Science, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado, USA.
J Med Virol. 2023 Jan;95(1):e28318. doi: 10.1002/jmv.28318. Epub 2022 Nov 24.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants and re-emergence of other respiratory viruses highlight the need to understand the presentation of and factors associated with SARS-CoV-2 in pediatric populations over time. The objective of this study was to evaluate the sociodemographic characteristics, symptoms, and epidemiological risk factors associated with ambulatory SARS-CoV-2 infection in children and determine if factors differ by variant type. We conducted a retrospective cohort study of outpatient children undergoing SARS-CoV-2 polymerase chain reaction testing between November 2020 and January 2022. Test-positive were compared with test-negative children to evaluate symptoms, exposure risk, demographics, and comparisons between Omicron, Delta, and pre-Delta time periods. Among 2264 encounters, 361 (15.9%) were positive for SARS-CoV-2. The cohort was predominantly Hispanic (51%), 5-11 years (44%), and 53% male; 5% had received two coronavirus disease 2019 (COVID-19) vaccine doses. Factors associated with a positive test include loss of taste/smell (adjusted odds ratio [aOR]: 6.71, [95% confidence interval, CI: 2.99-15.08]), new cough (aOR: 2.38, [95% CI: 1.69-3.36]), headache (aOR: 1.90, [95% CI: 1.28-2.81), fever (aOR: 1.83, [95% CI: 1.29-2.60]), contact with a positive case (aOR: 5.12, [95% CI: 3.75-6.97]), or household contact (aOR: 2.66, [95% CI: 1.96-3.62]). Among positive children, loss of taste/smell was more predominant during the Delta versus Omicron and pre-Delta periods (12% vs. 2% and 3%, respectively, p = 0.0017), cough predominated during Delta/Omicron periods more than the pre-Delta period (69% and 65% vs. 41%, p = 0.0002), and there were more asymptomatic children in the pre-Delta period (30% vs. 18% and 10%, p = 0.0023). These findings demonstrate that the presentation of COVID-19 in children and most susceptible age groups has changed over time.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）变异株以及其他呼吸道病毒的再度出现，凸显了随着时间推移了解儿科人群中SARS-CoV-2的表现及相关因素的必要性。本研究的目的是评估与儿童门诊SARS-CoV-2感染相关的社会人口学特征、症状和流行病学危险因素，并确定这些因素是否因变异株类型而异。我们对2020年11月至2022年1月期间接受SARS-CoV-2聚合酶链反应检测的门诊儿童进行了一项回顾性队列研究。将检测呈阳性的儿童与检测呈阴性的儿童进行比较，以评估症状、暴露风险、人口统计学特征，以及奥密克戎、德尔塔和德尔塔之前时期之间的差异。在2264次就诊中，361例（15.9%）SARS-CoV-2检测呈阳性。该队列主要为西班牙裔（51%），年龄在5至11岁（44%），男性占53%；5%的儿童接种了两剂2019冠状病毒病（COVID-19）疫苗。与检测呈阳性相关的因素包括味觉/嗅觉丧失（调整比值比[aOR]：6.71，[95%置信区间，CI：2.99 - 15.08]）、新发咳嗽（aOR：2.38，[95%CI：1.69 - 3.36]）、头痛（aOR：1.90，[95%CI：1.28 - 2.81]）、发热（aOR：1.83，[95%CI：1.29 - 2.60]）、与阳性病例接触（aOR：5.12，[95%CI：3.75 - 6.97]）或家庭接触（aOR：2.66，[95%CI：1.96 - 3.62]）。在检测呈阳性的儿童中，德尔塔时期味觉/嗅觉丧失比奥密克戎和德尔塔之前时期更常见（分别为12%对2%和3%，p = 0.0017），德尔塔/奥密克戎时期咳嗽比德尔塔之前时期更常见（69%和65%对41%，p = 0.0002），德尔塔之前时期无症状儿童更多（30%对18%和10%，p = 0.0023）。这些发现表明，儿童及大多数易感年龄组中COVID-19的表现随时间发生了变化。
