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新冠病毒在进化后是否更像季节性冠状病毒了?

Is SARS-CoV-2 Now More Like the Seasonal Coronaviruses Following Its Evolution?

机构信息

From the Department of Pediatric Infectious Disease, Faculty of Medicine, Ankara Yıldırım Beyazıt University.

Department of General Pediatrics.

出版信息

Pediatr Infect Dis J. 2024 Jul 1;43(7):682-686. doi: 10.1097/INF.0000000000004327. Epub 2024 Mar 21.

Abstract

BACKGROUND

SARS-CoV-2 has evolved significantly since the beginning of the COVID-19 pandemic. COVID-19 mortality has decreased due to increased population immunity and possibly the reduced intrinsic severity of the new variants. SARS-CoV-2 is now considered an endemic virus, but the extent to which its clinical findings resemble those of seasonal coronaviruses (sCoV) is not fully understood.

METHODS

Pediatric patients under 18 years of age who were sent for SARS-CoV-2 polymerase chain reaction real-time reverse transcription polymerase chain reaction between January 1, 2022 and January 14, 2023 and whose results were positive were included in this study. To include only symptomatic COVID-19 patients in the study, asymptomatic patients who were positive in their screening tests were excluded. For the sCoV patients' group, patients who had a respiratory viral polymerase chain reaction assay between January 10, 2022 and January 11, 2023 and were positive for any type of sCoV were included in the study. The 2 groups were compared for clinical and laboratory characteristics.

RESULTS

The study included 213 patients with COVID-19 and 194 patients with sCoV infection. Fever was a more common symptom in patients with COVID-19. sCoV was associated with lower respiratory involvement while increasing age was protective. The likelihood of hospitalization was decreased by increasing age but increased by the presence of comorbid conditions and lower respiratory tract involvement. The type of virus had no effect on the likelihood of hospitalization.

CONCLUSIONS

In conclusion, sCoV infections carry a higher risk for lower respiratory involvement than COVID-19, and COVID-19 has a milder course than sCoV infections in children.

摘要

背景

自 COVID-19 大流行开始以来,SARS-CoV-2 发生了显著进化。由于人群免疫力的提高和新变体内在严重程度的降低,COVID-19 死亡率有所下降。SARS-CoV-2 现在被认为是一种地方性病毒,但人们对其临床表现与季节性冠状病毒(sCoV)的相似程度仍不完全了解。

方法

本研究纳入了 2022 年 1 月 1 日至 2023 年 1 月 14 日期间因 SARS-CoV-2 聚合酶链反应实时逆转录聚合酶链反应而接受检测且结果为阳性的 18 岁以下儿科患者。为了仅将有症状的 COVID-19 患者纳入研究,排除了筛查试验呈阳性但无症状的患者。对于 sCoV 患者组,纳入了 2022 年 1 月 10 日至 2023 年 1 月 11 日期间进行呼吸道病毒聚合酶链反应检测且任何类型 sCoV 呈阳性的患者。比较了两组的临床和实验室特征。

结果

本研究纳入了 213 例 COVID-19 患者和 194 例 sCoV 感染患者。发热是 COVID-19 患者更常见的症状。sCoV 与下呼吸道受累有关,而年龄增加则具有保护作用。随着年龄的增长,住院的可能性降低,但随着合并症的存在和下呼吸道受累的增加,住院的可能性增加。病毒类型对住院的可能性没有影响。

结论

总之,与 COVID-19 相比,sCoV 感染更易导致下呼吸道受累,而 COVID-19 对儿童的严重程度低于 sCoV 感染。

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