Wilde Harrison, Tomlinson Christopher, Mateen Bilal A, Selby David, Kanthimathinathan Hari Krishnan, Denaxas Spiros, Flaxman Seth, Vollmer Sebastian, Pagel Christina, Brown Katherine
Institute of Health Informatics, University College London (UCL), London, United Kingdom.
Institute of Health Informatics, University College London (UCL), London, United Kingdom; UK Research and Innovation Centre for Doctoral Training in AI-enabled Healthcare Systems, UCL, London, United Kingdom; UCL Hospitals Biomedical Research Centre, UCL, London, United Kingdom.
J Pediatr. 2025 Jan;276:114370. doi: 10.1016/j.jpeds.2024.114370. Epub 2024 Oct 18.
To investigate the changing characteristics of SARS-CoV-2-related pediatric hospital admissions over time.
This was a national, observational cohort study from July 1, 2020, to August 31, 2023, using English population-linked electronic health records. We identified 45 203 children younger than 18 years old in whom SARS-CoV-2 either caused or contributed to hospitalization, excluding those admitted with "incidental" infection. Studied outcomes were types of hospitalization and severe hospitalizations involving either critical care or pediatric inflammatory multisystem syndrome-temporally associated with SARS-CoV-2 (PIMS-TS).
There were 45 920 SARS-CoV-2-related hospitalizations in children: 34 870 (75.9%) attributable to COVID-19; 1845 (4.0%) attributable to PIMS-TS; 8330 (18.1%) with SARS-CoV-2 as contributor to admission; and 875 (1.9%) acquired nosocomial SARS-CoV-2 infection. The most notable changes between the first 3 waves (March 2020 through November 2021) and the Omicron era (December 2021 onwards) were a decrease in PIMS-TS from 1575 of 14 020 (11.2%) to 270 of 31 905 (0.8%); a reduction in critical care use from 1175 of 14 020 (8.4%) to 1390 of 31 905 (4.4%); a decreased in mortality rate among those hospitalized from 521 per 100 000 to 249 per 100 000; and a decrease in the median age of hospitalized children from 4.7 (IQR 0.6,12.3) to 1.1 (IQR 0.3,6.4) years. Of children hospitalized, infants, 10.2% of whom had a recorded underlying health condition, comprised 4225 of 14 020 (30.1%) admissions 2020 through 2021 and 15 555 of 31 900 (48.8%) since 2022. (P < .001 for all comparisons).
Infants are now the pediatric age group most affected by SARS-CoV-2, at least partially because they have the least immunity to the virus, and are most vulnerable to respiratory illnesses.
调查新型冠状病毒2（SARS-CoV-2）相关儿童住院情况随时间的变化特征。
这是一项全国性观察性队列研究，时间跨度为2020年7月1日至2023年8月31日，使用与英国人口相关的电子健康记录。我们确定了45203名18岁以下儿童，SARS-CoV-2导致或促使其住院，排除那些因“偶然”感染而入院的儿童。研究结果包括住院类型以及涉及重症监护或与SARS-CoV-2时间相关的儿童炎症性多系统综合征（PIMS-TS）的严重住院情况。
儿童中有45920例与SARS-CoV-2相关的住院病例：34870例（75.9%）归因于冠状病毒病（COVID-19）；1845例（4.0%）归因于PIMS-TS；8330例（18.1%）中SARS-CoV-2是入院的促成因素；875例（1.9%）为医院获得性SARS-CoV-2感染。前三波疫情（2020年3月至2021年11月）和奥密克戎时代（2021年12月起）之间最显著的变化包括：PIMS-TS从14020例中的1575例（11.2%）降至31905例中的270例（0.8%）；重症监护的使用从14020例中的1175例（8.4%）降至31905例中的1390例（4.4%）；住院患者的死亡率从每10万人521例降至每10万人249例；住院儿童的中位年龄从4.7岁（四分位间距0.6，12.3）降至1.1岁（四分位间距0.3，6.4）。在住院儿童中，婴儿占2020年至2021年14020例入院病例中的4225例（30.1%），自202年以来占31900例中的15555例（48.8%），其中10.2%有记录在案的潜在健康状况。（所有比较P<0.001）。
婴儿现在是受SARS-CoV-2影响最大的儿童年龄组，至少部分原因是他们对该病毒的免疫力最低，且最易患呼吸道疾病。
