Recher Morgan, Leteurtre Stéphane, Javouhey Etienne, Morin Luc, Baudin Florent, Rambaud Jérôme, Mortamet Guillaume, Hubert Hervé, Angoulvant François, Levy Michael
Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France.
Pediatric Intensive Care Unit, Hôpital Femme Mère Enfant, Université de Lyon, Lyon, France, France.
J Pediatric Infect Dis Soc. 2023 Apr 28;12(4):189-197. doi: 10.1093/jpids/piad010.
The severity of SARS-CoV-2-related diseases in children remains unclear. This study aimed to describe the incidence of French pediatric intensive care units (PICUs) admissions with acute COVID-19, incidental positive SARS-CoV-2 test result, and multisystem inflammatory syndrome in children (MIS-C) during the delta and omicron variant periods.
This study used the French PICU registry to obtain data on all patients admitted to 41 French PICUs diagnosed with acute COVID-19, incidental positive SARS-CoV-2 test result, or MIS-C between August 30, 2021 and April 20, 2022. Data regarding the total number of positive SARS-CoV-2 polymerase chain reaction results according to the type of variants were obtained from the French National Public Health Agency.
Of 745 children, 244 (32.8%) were admitted for acute COVID-19, 246 (33.0%) for incidental positive SARS-CoV-2 test results, and 255 (34.2%) for MIS-C. The incidence of each group was higher with delta than with omicron. The incidence rate ratios with the delta variant were 7.47 (95% CI, 4.22-13.26) for acute COVID-19, 4·78 (95% CI, 2.30-9.94) for incidental positive SARS-CoV-2 test results, and 10.46 (95% CI, 5.98-18.31) for MIS-C compared to the omicron variant. The median age was 66 (7.7-126.8) months; 314 (42%) patients had comorbidities. Patients with acute COVID-19 and incidental positive SARS-CoV-2 test results had similar proportions of comorbidities. No patient with MIS-C died, whereas the mortality rates in the acute COVID-19 and incidental positive SARS-CoV-2 test results groups were 6.8% and 3.8%, respectively.
The incidence of acute COVID-19, incidental positive SARS-CoV-2 test results, and MIS-C admitted to the PICU were significantly higher with the delta variant than with the omicron variant.
儿童感染新型严重急性呼吸综合征冠状病毒2（SARS-CoV-2）相关疾病的严重程度尚不清楚。本研究旨在描述在德尔塔变异株和奥密克戎变异株流行期间，法国儿科重症监护病房（PICU）收治的急性冠状病毒病2019（COVID-19）、SARS-CoV-2检测偶然阳性结果以及儿童多系统炎症综合征（MIS-C）的发生率。
本研究利用法国PICU登记系统获取2021年8月30日至2022年4月20日期间，法国41家PICU收治的所有诊断为急性COVID-19、SARS-CoV-2检测偶然阳性结果或MIS-C的患者的数据。根据变异株类型划分的SARS-CoV-2聚合酶链反应阳性结果总数的数据，来自法国国家公共卫生机构。
745名儿童中，244名（32.8%）因急性COVID-19入院，246名（33.0%）因SARS-CoV-2检测偶然阳性结果入院，255名（34.2%）因MIS-C入院。每组的发生率在德尔塔变异株流行期间均高于奥密克戎变异株流行期间。与奥密克戎变异株相比，德尔塔变异株流行期间急性COVID-19的发病率比为7.47（95%CI，4.22-13.26），SARS-CoV-2检测偶然阳性结果的发病率比为4.78（95%CI，2.30-9.94），MIS-C的发病率比为10.46（95%CI，5.98-18.31）。中位年龄为66（7.7-126.8）个月；314名（42%）患者有合并症。急性COVID-19和SARS-CoV-2检测偶然阳性结果的患者合并症比例相似。MIS-C患者无死亡病例，而急性COVID-19组和SARS-CoV-2检测偶然阳性结果组的死亡率分别为6.8%和3.8%。
PICU收治的急性COVID-19、SARS-CoV-2检测偶然阳性结果以及MIS-C的发生率，在德尔塔变异株流行期间显著高于奥密克戎变异株流行期间。
