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2019冠状病毒病后时代儿童和青少年中与严重急性呼吸综合征冠状病毒2奥密克戎变异株相关的症状

Post-coronavirus disease 2019-associated symptoms among children and adolescents in the SARS-CoV-2 Omicron era.

作者信息

Schlegtendal Anne, Maier Christoph, Stein Julien, Höpner Jakob, Petersmann Astrid, Drinka Denisa, Berner Reinhard, Lücke Thomas, Toepfner Nicole, Brinkmann Folke

机构信息

University Children´s Hospital, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany.

Department of Medical Informatics, Biometry and Epidemiology, Ruhr-University Bochum, Bochum, Germany.

出版信息

Eur J Pediatr. 2024 Dec 21;184(1):96. doi: 10.1007/s00431-024-05919-3.

Abstract

PURPOSE

Lack of a control group(s) and selection bias were the main criticisms of previous studies investigating the prevalence of post-coronavirus disease 2019 (COVID-19) syndrome (PCS). There are insufficient data regarding paediatric PCS, particularly in the SARS-CoV-2 Omicron era. As such, our study investigated PCS-associated symptoms in a representative control-matched cohort.

METHODS

This multicentre, cross-sectional, cohort study within the "Immunebridge" project of the German Network University Medicine (NUM) recruited children and adolescents (five to 17 years old) between July and October 2022. Children with polymerase chain reaction-confirmed SARS-CoV-2 infection in 2022 (COVID-19 group) were compared with those without history of SARS-CoV-2 infection and negative for SARS-CoV-2 antibodies. Queries included vaccinations, quality of life (QoL), and mental and physical symptoms potentially associated with PCS in the previous three months. An additional composite item, "physical performance", was created from the responses.

RESULTS

The number of children with ≥ 1 PCS symptom(s) was comparable between the COVID-19 (n = 114 [62.1%]) and control (n = 66 [64.9%]) groups. Concentration disorders were reported more frequently in the COVID-19 group (12.3% versus 1.5%; p = 0.012) and "physical performance" was significantly impaired (p = 0.016) regardless of age, sex, and SARS-CoV-2 vaccination. The frequencies of other symptoms were similar in both groups. The COVID-19 group rated their fitness as worse, with otherwise equal QoL ratings regarding general and mental health. Conclusion Children with and without previous infections did not differ in most PCS-associated symptoms. Exceptions included physical performance and cognitive problems, which appeared to be more impaired after Omicron infection than in controls.

WHAT IS KNOWN

• Mainly due to too few controlled studies, knowledge about the prevalence of individual symptoms in paediatric post-COVID-19 syndrome (PCS) for the Omicron era is poor.

WHAT IS NEW

• In a representative control-matched cohort most parent-reported PCS-associated symptoms and quality of life scores in children and adolescents with PCR-confirmed SARS-CoV-2 infection did not differ from those without infection. • Exceptions were physical performance and cognitive problems, which were apparently more severely impaired after SARS-CoV-2-Omicron infection than in the control subjects.

摘要

目的

缺乏对照组和选择偏倚是以往关于2019冠状病毒病(COVID-19)综合征(PCS)患病率研究的主要批评点。关于儿童PCS的数据不足,尤其是在严重急性呼吸综合征冠状病毒2(SARS-CoV-2)奥密克戎时代。因此,我们的研究在一个具有代表性的对照匹配队列中调查了与PCS相关的症状。

方法

这项多中心、横断面队列研究是在德国大学医学网络(NUM)的“Immunebridge”项目中进行的,于2022年7月至10月招募了儿童和青少年(5至17岁)。将2022年经聚合酶链反应确诊感染SARS-CoV-2的儿童(COVID-19组)与无SARS-CoV-2感染史且SARS-CoV-2抗体检测呈阴性的儿童进行比较。询问内容包括疫苗接种情况、生活质量(QoL)以及前三个月可能与PCS相关的心理和身体症状。根据回答创建了一个额外的综合项目“身体机能”。

结果

COVID-19组(n = 114 [62.1%])和对照组(n = 66 [64.9%])中出现≥1种PCS症状的儿童数量相当。COVID-19组中注意力不集中障碍的报告更为频繁(12.3% 对1.5%;p = 0.012),且无论年龄、性别和SARS-CoV-2疫苗接种情况,“身体机能”均显著受损(p = 0.016)。两组中其他症状的出现频率相似。COVID-19组对自身健康状况的评价更差,而在总体和心理健康方面的QoL评分相当。结论:既往有感染和无感染的儿童在大多数与PCS相关的症状方面没有差异。例外情况包括身体机能和认知问题,在奥密克戎感染后,这些方面似乎比对照组受损更严重。

已知信息

• 主要由于对照研究过少,对于奥密克戎时代儿童COVID-19后综合征(PCS)中个体症状的患病率了解不足。

新发现

• 在一个具有代表性的对照匹配队列中,大多数家长报告的经PCR确诊感染SARS-CoV-2的儿童和青少年与PCS相关的症状及生活质量评分与未感染儿童无异。• 例外情况是身体机能和认知问题,在SARS-CoV-2奥密克戎感染后,这些方面显然比对照组受损更严重。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67b9/11662056/bc14e1bf7e76/431_2024_5919_Fig1_HTML.jpg

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