Sahin Aslıhan, Karadag-Oncel Eda, Buyuksen Osman, Ekemen-Keles Yildiz, Ustundag Gulnihan, Elvan-Tuz Aysegul, Tasar Selin, Didinmez-Taskirdi Elif, Baykan Muge, Kara-Aksay Ahu, Yilmaz Nisel, Olgac-Dundar Nihal, Yilmaz Dilek
Division of Pediatric Infectious Diseases, Health Sciences University Tepecik Training and Research Hospital, Izmir, Turkey.
Division of Pediatric Neurology Disease, Health Sciences University Tepecik Training and Research Hospital, Izmir, Turkey.
J Med Virol. 2023 Mar;95(3):e28628. doi: 10.1002/jmv.28628.
Since the COVID-19 pandemic began, various severe acute respiratory syndrome coronavirus 2 variants have been identified with different characteristics than the nonvariant strain. We retrospectively evaluated the demographic and clinical differences in the cohort of hospitalized COVID-19 children (1 month-18 years old) between March 11, 2020, and September 31, 2022, by the time the variants identified in our country predominate. Bonferroni post hoc analysis was performed to compare the differences between the periods. Of the 283 children in this study, 142 (50.2%) were females. The median age was 36 (interquartile range [IQR]: 7-132) months. Sixty-three (22.2%) patients were hospitalized in the nonvariant period, 24 (8.5%) in the Alpha period, 93 (32.9%) in the Delta period, and 103 (36.4%) in the Omicron period. Fever was the most common symptom in all groups, with no statistically significant differences (p = 0.25). In the Omicron period, respiratory and gastrointestinal symptoms decreased, and neurological symptoms increased significantly compared to other periods: [respiratory symptoms; nonvariant (65.1%) vs. Omicron (41.7%), (p = 0.024)], [gastrointestinal symptoms; Delta (41.9%) vs. Omicron (22.3%), (p = 0.018), [neurological symptoms; Delta (14.5%) vs. Omicron (31.1%), (p = 0.03]. Altered mental status and seizures were more common during the Omicron period compared to the pre-Omicron (nonvariant, Alpha, and Delta) period (p = 0.017 and p = 0.005, respectively). Although the main symptoms in children with COVID-19 were fever and respiratory symptoms, an increase in severe neurological manifestations was seen throughout the Omicron variant period.
自新冠疫情开始以来，已发现多种严重急性呼吸综合征冠状病毒2变种，其具有与非变种毒株不同的特征。我们回顾性评估了2020年3月11日至2022年9月31日期间我国主要流行变种毒株时住院的新冠儿童（1个月至18岁）队列中的人口统计学和临床差异。采用Bonferroni事后分析来比较各时期之间的差异。本研究中的283名儿童中，142名（50.2%）为女性。中位年龄为36（四分位间距[IQR]：7 - 132）个月。63名（22.2%）患者在非变种时期住院，24名（8.5%）在阿尔法时期住院，93名（32.9%）在德尔塔时期住院，103名（36.4%）在奥密克戎时期住院。发热是所有组中最常见的症状，无统计学显著差异（p = 0.25）。在奥密克戎时期，与其他时期相比，呼吸道和胃肠道症状减少，而神经症状显著增加：[呼吸道症状；非变种（65.1%）对奥密克戎（41.7%），（p = 0.024）]，[胃肠道症状；德尔塔（41.9%）对奥密克戎（22.3%），（p = 0.018）]，[神经症状；德尔塔（14.5%）对奥密克戎（31.1%），（p = 0.03）]。与奥密克戎之前（非变种、阿尔法和德尔塔）时期相比，奥密克戎时期精神状态改变和癫痫发作更为常见（分别为p = 0.017和p = 0.005）。尽管新冠儿童的主要症状是发热和呼吸道症状，但在整个奥密克戎变种时期严重神经表现有所增加。
