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[不同年龄组Delta变异株感染所致儿童新型冠状病毒肺炎2019的临床特征]

[Clinical features of children with coronavirus disease 2019 caused by Delta variant infection in different age groups].

作者信息

Su Hang, Duan Feng-Yang, Ren Xian-Qing, Zhang Xia, Yan Yong-Bin

机构信息

Department of Pediatrics, First Affiliated Hospital of Henan University of Traditional Chinese Medicine/College of Pediatrics, Henan University of Traditional Chinese Medicine, Zhengzhou 450000, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2023 Mar 15;25(3):289-294. doi: 10.7499/j.issn.1008-8830.2209102.

Abstract

OBJECTIVES

To study the clinical features of children with coronavirus disease 2019 (COVID-19) caused by Delta variant infection in different ages groups.

METHODS

A total of 45 children with COVID-19 caused by Delta variant infection who were hospitalized in the designated hospital in Henan Province, China, from November 17 to December 17, 2021, were included. They were divided into three groups: <6 years group (=16), 6-13 years group (=16), and >13 years group (=13). The three groups were compared in clinical features and laboratory examination data.

RESULTS

COVID-19 in all age groups was mainly mild. Main manifestations included cough and expectoration in the three groups, and fever was only observed in the 6-13 years group. The <6 years group had significantly higher serum levels of aspartate aminotransferase, lactate dehydrogenase, and creatine kinase isoenzymes than the other two groups (<0.05). The 6-13 years group had the highest proportion of children with elevated serum creatinine levels (50%). Among the three groups, only 4 children in the >13 years group had an increase in serum C-reactive protein levels. The 6-13 years group had the lowest counts of CD3CD4 lymphocytes, CD3CD8 lymphocytes, and natural killer cells in the peripheral blood among the three groups. The >13 years group had a significantly higher positive rate of SARS-CoV-2 IgG on admission than the other two groups (<0.05). There was no significant difference in the imaging findings on chest CT among the three groups (>0.05).

CONCLUSIONS

The clinical features of COVID-19 caused by Delta variant infection in children of different age groups may be different: children aged <6 years tend to develop myocardial injury, and those aged 6-13 years have fever except cough and expectoration and tend to develop renal and immune dysfunction.

摘要

目的

研究不同年龄组儿童感染德尔塔变异株所致新型冠状病毒肺炎(COVID-19)的临床特征。

方法

纳入2021年11月17日至12月17日在中国河南省指定医院住院的45例感染德尔塔变异株所致COVID-19患儿。将其分为三组:<6岁组(=16)、6 - 13岁组(=16)和>13岁组(=13)。对三组的临床特征和实验室检查数据进行比较。

结果

各年龄组的COVID-19主要为轻症。主要表现三组均有咳嗽、咳痰,发热仅在6 - 13岁组出现。<6岁组血清天门冬氨酸氨基转移酶、乳酸脱氢酶和肌酸激酶同工酶水平显著高于其他两组(<0.05)。6 - 13岁组血清肌酐水平升高的儿童比例最高(50%)。三组中,仅>13岁组有4例儿童血清C反应蛋白水平升高。6 - 13岁组外周血中CD3CD4淋巴细胞、CD3CD8淋巴细胞和自然杀伤细胞计数在三组中最低。>13岁组入院时SARS-CoV-2 IgG阳性率显著高于其他两组(<0.05)。三组胸部CT影像学表现差异无统计学意义(>0.05)。

结论

不同年龄组儿童感染德尔塔变异株所致COVID-19的临床特征可能不同:<6岁儿童易发生心肌损伤,6 - 13岁儿童除咳嗽、咳痰外有发热,且易发生肾脏和免疫功能障碍。

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本文引用的文献

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[Influence of coronavirus disease 2019 on the nervous system of children].[2019冠状病毒病对儿童神经系统的影响]
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Myocardial injury and COVID-19: Possible mechanisms.心肌损伤与 COVID-19:可能的机制。
Life Sci. 2020 Jul 15;253:117723. doi: 10.1016/j.lfs.2020.117723. Epub 2020 Apr 28.

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