Semeraro Michaela, Pinson Pierre, Populaire Margaux, Dellagi Mourad, Oualha Mehdi, Beeker Nathanael, Chappuy Hélène
Centre D'Investigation Clinique-Unité de Recherche Clinique, Hôpital Universitaire Necker Enfants-Malades, GH Paris Centre, Paris, France.
EA7323 Pediatric and Perinatal Drug Evaluation and Pharmacology, Université Paris Cité, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.
Front Pediatr. 2023 Feb 27;11:1044352. doi: 10.3389/fped.2023.1044352. eCollection 2023.
The clinical characteristics, disease progression and outcome in children affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection appear significantly milder compared to older individuals. Nevertheless, the trends in hospitalization and clinical characteristics in the pediatric population seem to be different over time across the different epidemic waves.
Our aim was to understand the impact of the different COVID-19 variants in the pediatric population hospitalized in the Pediatric Departments of the Public Hospital in the Greater Paris area by the analysis performed with the Assistance Publique-Hopitaux de Paris (AP-HP) Health Data Warehouse.
This is a retrospective cohort study including 9,163 patients under 18 years of age, hospitalized from 1 March 2020 to 22 March 2022, in the Paris area, with confirmed infection by SARS-CoV-2. Three mutually exclusive groups with decreasing severity (Pediatric Inflammatory Multisystem Syndrome (PIMS), symptomatic infection, mild or asymptomatic infection) were defined and described regarding demography, medical history, complication of the SARS-CoV-2 infection, and treatment during admission. Temporal evolution was described by defining three successive waves (March-September 2020, October 2020-October 2021, and November 2021-March 2022) corresponding to the emergence of the successive variants.
In the study period, 9,163 pediatric patients with SARS-CoV-2 infection were hospitalized in 21 AP-HP hospitals. The number of patients with SARS-CoV-2 infection increased over time for each wave of the pandemic (the mean number of patients per month during the first wave was 332, 322 during the 2nd, and 595 during the third wave). In the medical history, the most associated concomitant disease was chronic respiratory disease. Patients hospitalized during the third wave presented a higher incidence of pulmonary involvement (10.2% compared to 7% and 6.5% during the first and second waves, respectively). The highest incidence of PIMS was observed during the first and second waves (4.2% in the first and second waves compared to 2.3% in the 3rd wave).
This analysis highlighted the high incidence of hospitalized children in the Greater Paris Area during the third wave of SARS-CoV-2 pandemic corresponding to the Omicron Covid-19 variant, which is probably an expression of a concomitant SARS-CoV-2, while a decreased incidence of PIMS complication was observed during the same period.
与年长者相比，感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的儿童的临床特征、疾病进展和结局似乎明显较轻。然而，随着时间的推移，不同疫情波次中儿科人群的住院趋势和临床特征似乎有所不同。
我们的目的是通过使用巴黎公共救助医院集团（AP-HP）健康数据仓库进行分析，了解不同新冠病毒变异株对大巴黎地区公立医院儿科住院患者的影响。
这是一项回顾性队列研究，纳入了2020年3月1日至2022年3月22日期间在巴黎地区因SARS-CoV-2感染确诊而住院的9163名18岁以下患者。定义并描述了三个严重程度递减的相互排斥组（儿童炎症性多系统综合征（PIMS）、有症状感染、轻度或无症状感染）的人口统计学、病史、SARS-CoV-2感染并发症及入院期间的治疗情况。通过定义与连续变异株出现相对应的三个连续波次（2020年3月至9月、2020年10月至2021年10月、2021年11月至2022年3月）来描述时间演变。
在研究期间，9163名感染SARS-CoV-2的儿科患者在21家AP-HP医院住院。每一波疫情期间，SARS-CoV-2感染患者数量均随时间增加（第一波期间每月平均患者数量为332名，第二波为322名，第三波为595名）。在病史方面，最常伴发的疾病是慢性呼吸道疾病。第三波期间住院的患者肺部受累发生率更高（分别为10.2%，而第一波和第二波期间分别为7%和6.5%）。PIMS的最高发病率出现在第一波和第二波期间（第一波和第二波为4.2%，第三波为2.3%）。
该分析强调了在与奥密克戎新冠病毒变异株相对应的SARS-CoV-2大流行第三波期间，大巴黎地区住院儿童的高发病率，这可能是SARS-CoV-2共存的一种表现，而同期观察到PIMS并发症的发病率有所下降。
