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新型冠状病毒肺炎住院儿童患者疾病严重程度的表型变异:在EPICO研究中评估新型冠状病毒肺炎的影响

Phenotypic Variation in Disease Severity Among Hospitalized Pediatric Patients With COVID-19: Assessing the Impact of COVID-19 in the EPICO Study.

作者信息

Sossa-Alarcón María Camila, Gutiérrez Mónica Paola, Becerra Natalia, Ortegon Luz Yessenia, David María Camila, Vanegas Melisa Naranjo, Friedrich Gabriela, Vásquez-Hoyos Pablo, Mesa-Rubio María Lucía, Navarro-Ramirez Luis Miguel, Moreno-Lopez Sergio, Baquero Olga Lucía, Mejía Luz Marina, Piñeros Juan Gabriel, Restrepo-Gualteros Sonia, Álvarez-Moreno Carlos, Díaz-Díaz Alejandro, Gutierrez-Tobar Iván, Mesa Andrés Camilo, Bachiller Tuta William Ricardo, Galvis Diaz Clara Esperanza, Africano Martha, Nieto José Manuel, Pérez Camacho Paola Marcela, Beltrán-Arroyave Claudia, Vivas Trochez Rosalba, Gastesi Irati, Moraleda Cinta, Tagarro García Alfredo, Herrero Blanca, Calleja Lourdes, Grasa Carlos, Rodriguez Paula, Melendo Susana, Soriano-Arandes Antoni, Gómez Pastrana Irene, García García Sonsoles, Fumado Victoria, Ramírez Varela Andrea

机构信息

Pediatrics Department, Universidad de los Andes and Fundación Santa fe de Bogotá, Bogotá, Colombia.

School of Medicine, Universidad de los Andes, Bogotá, Colombia.

出版信息

Int J Public Health. 2025 Mar 18;70:1607246. doi: 10.3389/ijph.2025.1607246. eCollection 2025.

DOI:10.3389/ijph.2025.1607246
PMID:40170693
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11959304/
Abstract

OBJECTIVE

To characterize the clinical phenotypes of SARS-CoV-2 infection in hospitalized children as part of the EPICO multicenter cohort study.

METHODS

We included hospitalized children with confirmed SARS-CoV-2 infection from Colombian and Spanish institutions to assess disease evolution and outcomes. Cluster analysis was performed to identify clinical phenotypes.

RESULTS

A total of 2318 patients were included (55% male, 36% infants). Five phenotype clusters emerged: Cluster 1 (26.5%): infants without comorbidities, low PICU admissions and mortality; Cluster 2 (18.5%): respiratory comorbidities, high microorganism co-detection and mortality; Cluster 3 (11.5%): fever, gastrointestinal symptoms, high PICU admissions; Cluster 4 (32%): mild unspecific symptoms, low mortality; Cluster 5 (11.3%): adolescents without comorbidities, low co-detection and hospitalization rates. Findings were consistent across both countries.

CONCLUSION

Identifying clinical phenotypes of SARS-CoV-2 in children may improve risk stratification and guide future management strategies.

摘要

目的

作为EPICO多中心队列研究的一部分,对住院儿童中新型冠状病毒肺炎(SARS-CoV-2)感染的临床表型进行特征描述。

方法

我们纳入了来自哥伦比亚和西班牙机构的确诊SARS-CoV-2感染的住院儿童,以评估疾病进展和结局。进行聚类分析以识别临床表型。

结果

共纳入2318例患者(55%为男性,36%为婴儿)。出现了五个表型聚类:聚类1(26.5%):无合并症的婴儿,儿科重症监护病房(PICU)收治率和死亡率低;聚类2(18.5%):有呼吸系统合并症,微生物共检测率和死亡率高;聚类3(11.5%):发热、胃肠道症状,PICU收治率高;聚类4(32%):轻度非特异性症状,死亡率低;聚类5(11.3%):无合并症的青少年,共检测率和住院率低。两国的研究结果一致。

结论

识别儿童SARS-CoV-2的临床表型可能会改善风险分层并指导未来的管理策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53a3/11959304/d94367d9124a/ijph-70-1607246-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53a3/11959304/764daccc271e/ijph-70-1607246-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53a3/11959304/d94367d9124a/ijph-70-1607246-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53a3/11959304/764daccc271e/ijph-70-1607246-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53a3/11959304/d94367d9124a/ijph-70-1607246-g002.jpg

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本文引用的文献

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Human Adenovirus Infection Causing Hyperinflammatory Syndrome Mimicking Multisystem Inflammatory Syndrome in Children (MIS-C): A Case Report.人类腺病毒感染引发类似儿童多系统炎症综合征(MIS-C)的高炎症综合征:一例报告
Cureus. 2023 Jun 10;15(6):e40239. doi: 10.7759/cureus.40239. eCollection 2023 Jun.
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Front Pediatr. 2023 Apr 21;11:1060311. doi: 10.3389/fped.2023.1060311. eCollection 2023.
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Clinical and epidemiological features of pediatric population hospitalized with COVID-19: a multicenter longitudinal study (March 2020-December 2021) from Pakistan.新冠病毒病住院儿童的临床和流行病学特征:来自巴基斯坦的一项多中心纵向研究(2020年3月至2021年12月)
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