Gao Xiang, Li Debao, Cheng Xiuling, Xin Xiaoxia, Corno Antonio F, Boscarelli Alessandro, Du Xinping
Department of Orthopedics, Tianjin Fifth Central Hospital, Tianjin, China.
Department of Pediatrics, Tanggu Maternity Hospital, Tianjin, China.
Transl Pediatr. 2023 Jul 31;12(7):1396-1402. doi: 10.21037/tp-23-292. Epub 2023 Jul 25.
The children infected with the Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are at risk of progressing to severe disease. Clinical characteristics treatment measures and prognosis of these special age group of patients have not been completely understood which necessitate more researches. This study sought to analyze the clinical characteristics of children infected with the Omicron variant to provide evidences for the prevention, diagnosis and treatment of the Omicron variant infection in children.
The subjects of this study included children hospitalized for the Omicron variant at Tianjin Binhai Hospital in November 2022. The data were collected from the electronic medical record system, and the clinical characteristics of the children were analyzed. The primary endpoints included the clinical presentation, laboratory tests, virological characteristics, treatment regimen, and clinical prognosis of the patients.
A total of 49 patients were enrolled, of whom 32 (65.3%) were male. The patients had a median age of 10 (interquartile range, 6-11) years, and 34.7% of the patients received 2 or more coronavirus disease 2019 (COVID-19) vaccines. The main clinical manifestations of the patients were fever (79.6%) and cough (24.5%), with a maximum temperature of 42 ℃ and a median temperature of 39 (interquartile range, 38.4-39) ℃. The proportions of neutrophils and C-reactive protein were elevated by 50.0% and 25.0%, respectively. The total percentages of white blood cells and thrombocytopenia were 12.5% and 6.3%, respectively. D-dimer was examined in 6 cases, and was elevated to 1.77 μg/mL in 1 case (16.7%), and normal in 5 cases. The liver function, kidney function, and coagulation of 9 (100%) patients were all normal. After the anti-virus, anti-inflammatory response, antipyretic, and traditional Chinese medicine treatments, all the children were cured and discharged from the hospital. There were no severe cases.
The main manifestations of children infected with the SARS-CoV-2 Omicron variant were fever and cough. Some children had a high fever, nasal congestion, runny nose, gastrointestinal symptoms, and rash. A proportion of 12.5% of patients have a white blood cell count less than 4×10/L, and 6.3% have thrombocytopenia. The prognosis of the child was favorable after treatment with antiviral, antipyretic, and traditional Chinese medicine.
感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）奥密克戎变异株的儿童有进展为重症疾病的风险。这类特殊年龄组患者的临床特征、治疗措施及预后尚未完全明确，需要更多研究。本研究旨在分析感染奥密克戎变异株儿童的临床特征，为儿童奥密克戎变异株感染的预防、诊断及治疗提供依据。
本研究的对象包括2022年11月在天津滨海医院因感染奥密克戎变异株住院的儿童。数据从电子病历系统收集，并对儿童的临床特征进行分析。主要终点包括患者的临床表现、实验室检查、病毒学特征、治疗方案及临床预后。
共纳入49例患者，其中男性32例（65.3%）。患者中位年龄为10岁（四分位间距，6 - 11岁），34.7%的患者接种了2剂或更多剂2019冠状病毒病（COVID-19）疫苗。患者的主要临床表现为发热（79.6%）和咳嗽（24.5%），最高体温42℃，中位体温39℃（四分位间距，38.4 - 39℃）。中性粒细胞和C反应蛋白比例分别升高50.0%和25.0%。白细胞减少和血小板减少的总比例分别为12.5%和6.3%。6例检测了D-二聚体，1例（16.7%）升高至1.77μg/mL，5例正常。9例（100%）患者的肝功能、肾功能及凝血功能均正常。经过抗病毒、抗炎、退热及中药治疗后，所有儿童均治愈出院。无重症病例。
感染SARS-CoV-2奥密克戎变异株的儿童主要表现为发热和咳嗽。部分儿童有高热、鼻塞、流涕、胃肠道症状及皮疹。12.5%的患者白细胞计数低于4×10⁹/L，6.3%有血小板减少。经抗病毒、退热及中药治疗后儿童预后良好。
