新冠疫情第一波期间慢性病患儿与健康儿童及成人的新冠病毒血清转化情况比较。
Comparison of SARS-CoV-2 seroconversion in children with chronic diseases with healthy children and adults during the first waves of the COVID-19 pandemic.
作者信息
Hoste Levi, Prytula Agnieszka, Dehoorne Jo, De Bruyne Ruth, Van Biervliet Stephanie, De Waele Kathleen, Maes Evelyn, Bordon Victoria, Vanlander Arnaud, Claes Karlien, Vande Walle Johan, Schelstraete Petra, Van Daele Sabine, Haerynck Filomeen
机构信息
Department of Pediatric Pulmonology, Infectious Diseases and Immunology, Ghent University Hospital, Ghent, Belgium.
Primary Immunodeficiency Research Lab, Centre for Primary Immunodeficiency Ghent, Jeffrey Modell Diagnosis and Research Centre, Ghent University Hospital, Ghent, Belgium.
出版信息
Front Pediatr. 2023 Aug 7;11:1210181. doi: 10.3389/fped.2023.1210181. eCollection 2023.
BACKGROUND
Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is clinically diverse, and children have a low risk of developing severe coronavirus disease 2019 (COVID-19). However, children with chronic diseases have a potentially increased risk.
METHODS
We performed a prospective surveillance study with longitudinal serum SARS-CoV-2 anti-nucleocapsid antibody quantification and questionnaires in pediatric tertiary care patients during the first waves of the COVID-19 pandemic (November 2020-September 2021). The results were compared with those of healthy children and adults from the same geographic area.
RESULTS
We obtained 525 samples from 362 patients (M/F ratio of 1.3:1; median age of 11.1 years) comprising children with immune-suppressive or immune-modulating drugs (32.9%), inborn errors of immunity (23.5%), type 1 diabetes mellitus (15.2%), and rheumatic diseases (11.9%). A total of 51 (9.7%) samples were seropositive among 37/351 children (10.5%). Seropositivity increased from 5.8% in November-December 2020 to 21.6% in July-September 2021. Compared with adults, a longitudinal analysis revealed reduced seroprevalence but similar kinetics as in children from the same country. Demographic or social variables and disease characteristics did not correlate with seropositivity. Being obese and household contact with COVID-19-infected individuals significantly increased the odds of infection. The majority of seropositive patients had mild symptoms (21/37). One-third were asymptomatic and/or unaware of having COVID-19 (10/37). Four patients (4/37) needed hospitalization, with good clinical outcomes.
CONCLUSIONS
Although harboring a chronic disease, we observed a low SARS-CoV-2 incidence in a cohort of pediatric tertiary care patients, comparable with healthy children during the first year of the pandemic. Infection was mostly associated with mild symptoms.
背景
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染的临床表现多样，儿童患重症冠状病毒病2019（COVID-19）的风险较低。然而，患有慢性病的儿童风险可能会增加。
方法
在COVID-19大流行的第一波期间（2020年11月至2021年9月），我们对儿科三级护理患者进行了一项前瞻性监测研究，对血清SARS-CoV-2抗核衣壳抗体进行纵向定量分析并开展问卷调查。将结果与来自同一地理区域的健康儿童和成人的结果进行比较。
结果
我们从362名患者中获取了525份样本（男/女比例为1.3:1；中位年龄为11.1岁），这些患者包括使用免疫抑制或免疫调节药物的儿童（32.9%）、先天性免疫缺陷患者（23.5%）、1型糖尿病患者（15.2%）和风湿性疾病患者（11.9%）。在37/351名儿童（10.5%）中，共有51份（9.7%）样本血清呈阳性。血清阳性率从2020年11月至12月的5.8%上升至2021年7月至9月的21.6%。与成人相比，纵向分析显示血清阳性率较低，但与来自同一国家的儿童的血清阳性率变化趋势相似。人口统计学或社会变量以及疾病特征与血清阳性无关。肥胖以及与COVID-19感染者有家庭接触会显著增加感染几率。大多数血清阳性患者症状较轻（21/37）。三分之一的患者无症状和/或未意识到感染了COVID-19（10/37）。4名患者（4/37）需要住院治疗，临床结局良好。
结论
尽管患有慢性病，但我们观察到一组儿科三级护理患者中SARS-CoV-2感染率较低，与大流行第一年的健康儿童相当。感染大多与轻微症状相关。
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