Cimolai Nevio
Faculty of Medicine, The University of British Columbia and Children's and Women's Health Centre of British Columbia, Vancouver, Canada.
Clin Exp Pediatr. 2024 Jan;67(1):1-16. doi: 10.3345/cep.2023.00794. Epub 2023 Nov 27.
Infants aged <1 year represent a seemingly more susceptible pediatric subset for infections. Despite this, coronavirus disease 2019 (COVID-19) infection has not been proven as more serious in this age group (outside the very early neonatal period) than in others. Indeed, a considerable number of asymptomatic infections have been recorded, and the symptoms and morbidity associated with COVID- 19 differ minimally from those of other respiratory viral infections. Whether due to an abundance of caution or truly reduced susceptibility, infections in infants have not raised the same profile as those in other age groups. In addition to direct severe acute respiratory syndrome coronavirus 2 diagnostic tests, laboratory markers that differentiate COVID-19 from other viral infections lack specificity in infants. Gastrointestinal presentations are common, and the neurological complications of infection mirror those of other respiratory viral infections. There have been relatively few reports of infant deaths. Under appropriate precautions, breastfeeding in the context of maternal infections has been associated with tangible but infrequent complications. Vaccination during pregnancy provides protection against infection in infants, at least in the early months of life. Multi-inflammatory syndrome in children and multi-inflammatory syndrome in neonates are commonly cited as variants of COVID-19; however, their clinical definitions remain controversial. Similarly, reliable definitions of long COVID in the infant group are controversial. This narrative review examines the key clinical and laboratory features of COVID-19 in infants and identifies several areas of science awaiting further clarification.
1岁以下的婴儿似乎是更容易感染的儿科亚组。尽管如此，2019冠状病毒病（COVID-19）感染在这个年龄组（极早期新生儿期除外）并未被证明比其他年龄组更严重。事实上，已经记录到相当数量的无症状感染，而且与COVID-19相关的症状和发病率与其他呼吸道病毒感染的症状和发病率差异极小。无论是出于过度谨慎还是真正的易感性降低，婴儿感染并未引起与其他年龄组相同的关注。除了直接的严重急性呼吸综合征冠状病毒2诊断测试外，区分COVID-19与其他病毒感染的实验室标志物在婴儿中缺乏特异性。胃肠道症状很常见，感染的神经并发症与其他呼吸道病毒感染的并发症相似。婴儿死亡的报告相对较少。在适当的预防措施下，母亲感染时进行母乳喂养会出现一些明显但不常见的并发症。孕期接种疫苗可为婴儿提供抗感染保护，至少在生命的最初几个月是这样。儿童多炎症综合征和新生儿多炎症综合征通常被认为是COVID-19的变体；然而，它们的临床定义仍存在争议。同样，婴儿组中“长期COVID”的可靠定义也存在争议。这篇叙述性综述探讨了婴儿COVID-19的关键临床和实验室特征，并确定了几个有待进一步澄清的科学领域。
