儿科患者喉炎严重程度及治疗的比较分析：一项关于奥密克戎毒株高峰期新冠病毒检测呈阳性与阴性病例的研究
Comparative analysis of croup severity and treatment in pediatric patient: a study of COVID-19 positive vs. negative cases during peak Omicron.
作者信息
Pourjoula Fatemeh, Mirlohi Seyed Hossein, Ghanbari Niloufar
机构信息
Tehran University of Medical Sciences, school of medicine, Tehran, Iran.
Pediatric Respiratory Disease and Sleep Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran.
出版信息
BMC Pediatr. 2025 Mar 15;25(1):194. doi: 10.1186/s12887-025-05536-5.
BACKGROUND
The Omicron variant of SARS-CoV-2 has been associated with unique clinical presentations in children, including croup-like symptoms such as barking cough, hoarseness, and respiratory distress. This study aimed to compare the clinical, laboratory, and treatment characteristics of hospitalized pediatric patients with croup who tested positive or negative for COVID-19 during the Omicron wave.
METHODS
A retrospective, descriptive-analytical study was conducted on 111 pediatric patients hospitalized with croup at Bahrami Children's Hospital and the Children's Medical Center in Iran from January 21 to March 20, 2022. Patients were categorized into two groups: PCR-positive (Omicron group, n = 30) and PCR-negative (non-Omicron group, n = 81). Data on demographics, clinical severity, laboratory indices, treatments, and outcomes were extracted and analyzed using SPSS version 20.
RESULTS
The mean age of the Omicron group was significantly younger (16.93 ± 24.80 months) compared to the non-Omicron group (32.58 ± 37.26 months; p = 0.049). Symptom severity was higher in the Omicron group, with moderate to severe symptoms observed in 73.4% of patients, compared to 32.1% in the non-Omicron group (p = 0.001). The Omicron group had longer hospital stays (2.59 ± 3.93 vs. 2.11 ± 2.75 days; p = 0.016) and required more nebulized epinephrine (2.47 ± 1.27 vs. 1.77 ± 1.003 days; p = 0.003) and repeat corticosteroid doses (83.3% vs. 38.3%; p = 0.0001). Laboratory findings showed no significant differences between the groups (all p > 0.05).
CONCLUSION
Children with croup during the Omicron surge exhibited increased symptom severity, required more intensive treatment, and experienced longer hospital stays compared to those without COVID-19. These findings emphasize the need for heightened clinical awareness and tailored management strategies for Omicron-related croup in pediatric populations.
背景
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的奥密克戎变异株与儿童独特的临床表现有关，包括哮吼样症状，如犬吠样咳嗽、声音嘶哑和呼吸窘迫。本研究旨在比较奥密克戎疫情期间新冠病毒检测呈阳性或阴性的住院哮吼患儿的临床、实验室和治疗特征。
方法
对2022年1月21日至3月20日在伊朗巴赫拉米儿童医院和儿童医学中心住院的111例哮吼患儿进行了一项回顾性描述性分析研究。患者分为两组：PCR阳性（奥密克戎组，n = 30）和PCR阴性（非奥密克戎组，n = 81）。使用SPSS 20版提取并分析人口统计学、临床严重程度、实验室指标、治疗和结局数据。
结果
奥密克戎组的平均年龄（16.93±24.80个月）显著低于非奥密克戎组（32.58±37.26个月；p = 0.049）。奥密克戎组的症状严重程度更高，73.4%的患者出现中度至重度症状，而非奥密克戎组为32.1%（p = 0.001）。奥密克戎组的住院时间更长（2.59±3.93天对2.11±2.75天；p = 0.016），需要更多的雾化肾上腺素治疗（2.47±1.27天对1.77±1.003天；p = 0.003）和重复使用皮质类固醇剂量（83.3%对38.3%；p = 0.0001）。实验室检查结果显示两组之间无显著差异（所有p>0.05）。
结论
与未感染新冠病毒的患儿相比，奥密克戎疫情期间患哮吼的儿童症状严重程度增加，需要更强化的治疗，住院时间更长。这些发现强调了对儿科人群中与奥密克戎相关的哮吼提高临床意识和制定针对性管理策略的必要性。
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