新型冠状病毒Omicron变异株流行期间不同年龄儿童感染的临床特征分析

Clinical features of children with coronavirus disease 2019 in different age groups during the epidemic of Omicron variant

摘要:

目的 探讨不同年龄儿童Omicron变异株流行期间新型冠状病毒感染（coronavirus disease 2019，COVID-19）临床特征的差异。方法 回顾性分析2022年12月9日—2023年1月8日于广东省中山市人民医院普通儿科住院确诊为COVID-19的211例患儿的临床资料，根据年龄分为1个月~<1岁组（84例）、1~<3岁组（64例）、3~<5岁组（29例）和≥5岁组（34例），分析比较不同年龄段儿童的一般情况、临床特征、实验室结果、诊治及转归的差异。结果 3岁以下儿童占COVID-19住院儿童70.1%（148/211），3~<5岁组、≥5岁组患儿合并基础疾病比例高于1个月~<1岁组和1~<3岁组（P<0.05）。与其他3组相比，1个月~<1岁组患儿呼吸困难、鼻塞/鼻涕、腹泻的比例更高，惊厥发作及神经系统受累比例更低（P<0.05）。并且，与其他3组相比，1个月~<1岁组患儿胆汁酸及肌酸激酶同工酶升高比例更高，血小板计数降低、中性粒细胞比例升高及淋巴细胞比例降低比例更低（P<0.05）。COVID-19分型上，1个月~<1岁组患儿轻型比例高于1~<3岁组，重型/危重型比例低于其他3组（P<0.05）。1个月~<1岁组患儿吸氧比例高于其他3组（P<0.05）。结论 不同年龄组儿童Omicron变异株流行期间COVID-19临床特征不同，尤其是1个月~<1岁与≥1岁患儿之间差异更明显。

Abstract:

Objective To study the differences in the clinical features of children with coronavirus disease 2019 (COVID-19) in different age groups during the epidemic of Omicron variant.Methods A retrospective analysis was performed on the clinical data of 211 children with COVID-19 who were admitted to the Department of General Pediatrics, Zhongshan People's Hospital, from December 9, 2022 to January 8, 2023. According to their age, they were divided into 4 groups: 1 month-<1 year (n=84), 1-<3 years group (n=64), 3-<5 years (n=29), and ≥5 years (n=34). The above groups were compared in terms of general status, clinical features, ancillary examination results, treatment, and outcome.Results The children aged <3 years accounted for 70.1% (148/211) of all hospitalized children with COVID-19, and the 3-<5 years group and the ≥5 years group had a significantly higher proportion of children with underlying diseases than the 1 month-<1 year group and the 1-<3 years group (P<0.05). Compared with the other three groups, the 1 month-<1 year group had significantly higher incidence rates of dyspnea, nasal congestion/nasal discharge, diarrhea and significantly lower incidence rates of convulsion and nervous system involvement (P<0.05). Moreover, compared with the other three groups, the 1 month-<1 year group had significantly higher incidence rates of increases in bile acid and creatine kinase isoenzyme and significantly lower incidence rates of decreased platelet count, increased neutrophil percentage, and decreased lymphocyte percentage (P<0.05). The 1 month-<1 year group had a significantly higher incidence rate of mild COVID-19 than the 1-<3 years group and a significantly lower incidence rate of severe/critical COVID-19 than the other three groups (P<0.05). Compared with the other three groups, the 1 month-<1 year group had a significantly higher proportion of children receiving oxygen inhalation therapy (P<0.05).Conclusions Children with COVID-19 in different age groups have different clinical features during the epidemic of Omicron variant, especially between the children aged 1 month to <1 year and those aged ≥1 year.