杭州市19例新型冠状病毒Omicron变异株感染儿童的临床特征

Clinical features of 19 children infected with the Omicron variant of severe acute respiratory syndrome coronavirus 2 in Hangzhou,China

摘要:

目的 探讨儿童新型冠状病毒Omicron变异株感染者的临床特征，为临床诊疗提供参考。 方法 回顾性分析杭州市19例2022年1月28日至3月3日确诊为新型冠状病毒Omicron变异株感染儿童的临床资料。 结果 19例患儿中，男性7例（37%），女性12例（63%）；年龄0.5~16.0岁，中位年龄为2岁1个月，以婴幼儿（≤3岁）多见（53%）。未接种新型冠状病毒疫苗者11例（58%），接种者8例（42%）。3例（16%）有基础疾病史。19例患儿均有明确的新型冠状病毒感染者的密切接触史，其中母婴看护机构聚集性发病10例（53%）。临床表现为轻型13例（68%），普通型6例（32%），无重型病例。最常见症状为咳嗽（100%）和发热（63%）。患儿外周血白细胞计数（84%）及淋巴细胞计数多正常（68%）。患儿的血小板计数、降钙素原、肝功能指标（丙氨酸氨基转移酶、天冬氨酸氨基转移酶）、肾功能指标（肌酐、尿素）无明显异常。6例（32%）胸部CT有明显肺炎征象。19例患儿均给予对症治疗，12例（63%）雾化吸入干扰素α。所有患儿治愈出院。 结论 儿童Omicron变异株感染病例以婴幼儿多见，症状轻，预后良好。患儿多有新型冠状病毒感染者的密切接触史，应重视母婴看护中心等婴幼儿集中场所的疫情防控。

Abstract:

Objective To study the clinical features of children infected with the Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods The medical data of 19 children who were diagnosed with SARS-CoV-2 Omicron variant infection from January 28 to March 3, 2022 in Hangzhou were retrospectively reviewed. Results Among the 19 children, there were 7 boys (37%) and 12 girls (63%), and their age ranged from 6 months to 16 years, with a median age of 2 years and 1 month. Most of these children were infants and young children (aged ≤3 years, accounting for 53%). Among these children, 11 (58%) were unvaccinated with SARS-CoV-2 vaccine and 8 (42%) were vaccinated with SARS-CoV-2 vaccine, and 3 children (16%) had a history of underlying diseases. All 19 children had a clear history of close contact with persons infected with SARS-CoV-2, and 10 children (53%) were involved in the cluster outbreak in a maternal and infant care center. In terms of clinical classification, 13 children (68%) had mild coronavirus disease 2019 (COVID-19) and 6 (32%) had common COVID-19, with no severe cases of COVID-19. The most common clinical symptoms were cough (100%) and fever (63%). The children with a normal peripheral white blood cell count accounted for 84%, and those with a normal lymphocyte count accounted for 68%. There were no significant abnormalities in platelet count, procalcitonin, liver function parameters (alanine aminotransferase and aspartate aminotransferase), and renal function parameters (creatinine and urea). Six children (32%) had obvious signs of pneumonia on chest CT. All 19 children were given symptomatic treatment, and 12 children (63%) were given aerosol inhalation of interferon α. All children were cured and discharged. Conclusions Children infected with Omicron variant strains are more common in infants and young children, with mild symptoms and good prognosis. Most of the children have a history of close contact with persons infected with SARS-CoV-2, and epidemic prevention and control should be strengthened in places with many infants and children, such as maternal and infant care centers.