新冠病毒病（COVID-19）急性期后儿童胃肠道结局：美国29家医院的“恢复计划”研究结果
Pediatric Gastrointestinal Outcomes During the Post-Acute Phase of COVID-19: Findings from RECOVER Initiative from 29 Hospitals in the US.
作者信息
Zhang Dazheng, Stein Ronen, Lu Yiwen, Zhou Ting, Lei Yuqing, Li Lu, Chen Jiajie, Arnold Jonathan, Becich Michael J, Chrischilles Elizabeth A, Chuang Cynthia H, Christakis Dimitri A, Fort Daniel, Geary Carol R, Hornig Mady, Kaushal Rainu, Liebovitz David M, Mosa Abu Saleh Mohammad, Morizono Hiroki, Mirhaji Parsa, Dotson Jennifer L, Pulgarin Claudia, Sills Marion R, Suresh Srinivasan, Williams David A, Baldassano Robert N, Forrest Christopher B, Chen Yong
机构信息
The Center for Health AI and Synthesis of Evidence (CHASE), University of Pennsylvania, Philadelphia, PA, United States.
Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States.
出版信息
medRxiv. 2024 Jul 9:2024.05.21.24307699. doi: 10.1101/2024.05.21.24307699.
IMPORTANCE
The profile of gastrointestinal (GI) outcomes that may affect children in post-acute and chronic phases of COVID-19 remains unclear.
OBJECTIVE
To investigate the risks of GI symptoms and disorders during the post-acute phase (28 days to 179 days after SARS-CoV-2 infection) and the chronic phase (180 days to 729 days after SARS-CoV-2 infection) in the pediatric population.
DESIGN
We used a retrospective cohort design from March 2020 to Sept 2023.
SETTING
twenty-nine healthcare institutions.
PARTICIPANTS
A total of 413,455 patients aged not above 18 with SARS-CoV-2 infection and 1,163,478 patients without SARS-CoV-2 infection.
EXPOSURES
Documented SARS-CoV-2 infection, including positive polymerase chain reaction (PCR), serology, or antigen tests for SARS-CoV-2, or diagnoses of COVID-19 and COVID-related conditions.
MAIN OUTCOMES AND MEASURES
Prespecified GI symptoms and disorders during two intervals: post-acute phase and chronic phase following the documented SARS-CoV-2 infection. The adjusted risk ratio (aRR) was determined using a stratified Poisson regression model, with strata computed based on the propensity score.
RESULTS
Our cohort comprised 1,576,933 patients, with females representing 48.0% of the sample. The analysis revealed that children with SARS-CoV-2 infection had an increased risk of developing at least one GI symptom or disorder in both the post-acute (8.64% vs. 6.85%; aRR 1.25, 95% CI 1.24-1.27) and chronic phases (12.60% vs. 9.47%; aRR 1.28, 95% CI 1.26-1.30) compared to uninfected peers. Specifically, the risk of abdominal pain was higher in COVID-19 positive patients during the post-acute phase (2.54% vs. 2.06%; aRR 1.14, 95% CI 1.11-1.17) and chronic phase (4.57% vs. 3.40%; aRR 1.24, 95% CI 1.22-1.27).
CONCLUSIONS AND RELEVANCE
In the post-acute phase or chronic phase of COVID-19, the risk of GI symptoms and disorders was increased for COVID-positive patients in the pediatric population.
重要性
在新冠病毒感染的急性后期和慢性期可能影响儿童的胃肠道（GI）结局情况仍不清楚。
目的
调查儿科人群在急性后期（新冠病毒感染后28天至179天）和慢性期（新冠病毒感染后180天至729天）出现胃肠道症状和疾病的风险。
设计
我们采用了2020年3月至2023年9月的回顾性队列设计。
设置
29家医疗机构。
参与者
共有413455名18岁及以下的新冠病毒感染患者和1163478名未感染新冠病毒的患者。
暴露因素
记录在案的新冠病毒感染，包括新冠病毒的聚合酶链反应（PCR）阳性、血清学检测阳性或抗原检测阳性，或新冠病毒感染及新冠相关病症的诊断。
主要结局和衡量指标
在记录的新冠病毒感染后的两个时间段（急性后期和慢性期）预先设定的胃肠道症状和疾病。使用分层泊松回归模型确定调整后的风险比（aRR），分层基于倾向得分计算。
结果
我们的队列包括1576933名患者，女性占样本的48.0%。分析显示，与未感染的同龄人相比，新冠病毒感染儿童在急性后期（8.64%对6.85%；aRR 1.25，95%CI 1.24 - 1.27）和慢性期（12.60%对9.47%；aRR 1.28，95%CI 1.26 - 1.30）出现至少一种胃肠道症状或疾病的风险增加。具体而言，新冠病毒感染阳性患者在急性后期（2.54%对2.06%；aRR 1.14，95%CI 1.11 - 1.
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