新生儿新型冠状病毒Omicron变异株感染23例临床分析

Clinical features of 23 neonates infected with Omicron variant of severe acute respiratory syndrome coronavirus 2

摘要:

目的 总结新生儿新型冠状病毒Omicron变异株感染病例的临床特点。方法 回顾性分析2022年10—12月乌鲁木齐市第一人民医院城北院区收治的23例新型冠状病毒Omicron变异株感染新生儿的临床资料。结果 23例患儿生后与新型冠状病毒感染确诊看护人有接触史，均非垂直传播。临床分型：无症状感染5例，轻型18例，无中型、重型及危重型病例。首发症状为发热13例，咳嗽3例，鼻塞1例，腹泻1例，同时多数病例存在一种或多种伴随症状。2例血白细胞计数减少，1例C反应蛋白增高。7例患儿因咳嗽或呼吸急促表现行胸部X线检查，提示其中1例局灶性渗出性改变，余未见异常改变。所有患儿对症治疗后均痊愈出院，住院时间中位数为6 d。N基因Ct值、ORF1ab基因Ct值与新型冠状病毒核酸持续阳性时间均呈负相关（r_s分别为-0.719、-0.699，均P<0.05）。出院后1个月随访，均无症状复现及核酸复阳表现。结论 新生儿新型冠状病毒Omicron变异株感染的临床表现通常为轻型或无症状型。新型冠状病毒核酸N和ORF1ab基因Ct值越低，核酸持续阳性时间越长。患儿经对症治疗后转归良好。

Abstract:

Objective To summarize the clinical features of neonates infected with Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).Methods The medical data of 23 neonates with Omicron variant of SARS-CoV-2 infection admitted to the City North Campus of Urumqi First People's Hospital from October to December 2022 were retrospectively reviewed.Results All 23 infants had a history of exposure to confirmed caregivers with SARS-CoV-2 infection after birth, and none of them was vertically transmitted. Clinical classification: 5 cases of asymptomatic infection, 18 cases of mild infection, and no cases of moderate, severe, or critically ill. The first symptoms were fever in 13 cases, cough in 3 cases, nasal congestion in 1 case, and diarrhea in 1 case. Blood white blood cell counts decreased in 2 cases, and C-reactive protein increased in 1 case. Seven infants underwent chest X-ray examination due to cough or shortness of breath, and one of which showed focal exudative changes, while the rest showed no abnormal changes. All infants were discharged after symptomatic treatment and the median hospital stay was 6 days. The duration of nucleic acid positivity of SARS-CoV-2 was negatively correlated with N gene Ct values and ORF1ab gene Ct values (r_s=-0.719 and -0.699, respectively; P<0.05). One month after discharge, all infants had no symptoms or signs of nucleic acid re-positivity.Conclusions The clinical manifestations are usually mild or asymptomatic in neonates infected with SARS-CoV-2 Omicron variant. The lower the Ct values of the N and ORF1ab genes of SARS-CoV-2, the longer the duration of nucleic acid positivity. Neonates infected with SARS-CoV-2 Omicron variant can have a good prognosis after symptomatic treatment.