儿童感染 Omicron 和 Delta SARS-CoV-2 的临床严重程度。

IF 1 4区 医学 Q3 PEDIATRICS Pediatrics International Pub Date : 2024-01-01 DOI:10.1111/ped.15777
David Chun-Ern Ng, Chuin-Hen Liew, Kah Kee Tan, Ling Chin, Elida Hanan Binti Awang, Debashini A/P Chandirasekharan, Maryam Jamilah Binti Surdi Roslan, Munzir Bin Jamil, Nor Zanariah Zainol Abidin, Yee Keat Cheah, Mohd Ferous Bin Alias, Erwin Jiayuan Khoo
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引用次数: 0

摘要

背景:我们旨在比较2019年冠状病毒病(COVID-19)住院儿童中Omicron和Delta变体感染的临床特征和严重程度:我们旨在比较2019年冠状病毒病(COVID-19)住院儿童中Omicron和Delta变异型感染的临床特征和严重程度:方法:通过州立儿科 COVID-19 登记处确定了 2021 年 1 月 1 日至 2022 年 3 月 31 日期间在五家医院因 COVID-19 住院的 12 岁或以下儿童。对既往未感染过 COVID-19、未接种过 COVID-19 疫苗或未合并感染的 Delta 和 Omicron 感染者进行倾向分数 1:1 匹配,以控制基线特征的差异。对临床表现、治疗和结果进行了分析。疾病严重程度采用改编的世界卫生组织序数量表进行评估:在最初的 1367 名患者中,668 人感染了德尔塔病毒,699 人感染了奥米克龙病毒。倾向分数匹配产生了 558 对匹配患者。与德尔塔感染的患者相比,奥米克龙感染的患者更有可能出现气胸(比值比为 10.87,95% 置信区间为 2.54 至 46.59)、下呼吸道感染(比值比为 2.32,95% 置信区间为 1.48 至 3.64)和癫痫发作(比值比为 8.39,95% 置信区间为 5.04 至 13.99)。Omicron 与中度/重度疾病的几率增加(OR 6.14,95% CI,4.72-7.99)、更需要静脉输液治疗(OR 6.00,95% CI,4.29-8.39)、皮质类固醇(OR 3.08,95% CI,1.66-5.72)、经验性抗生素(OR 1.70,95% CI,1.10-2.64)以及低流量鼻氧疗法(OR 3.68,95% CI,2.17-6.22):结论:与德尔塔感染相比,奥米克龙感染住院患儿的临床表现截然不同,患中度/重度疾病的可能性更大,对医疗资源的利用率更高。
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Clinical severity of Omicron and Delta SARS-CoV-2 infections in children.

Background: We aimed to compare the clinical features and severity of the Omicron and Delta variant infections among children hospitalized for coronavirus disease 2019 (COVID-19).

Methods: Children 12 years old or less hospitalized for COVID-19 across five hospitals between January 1, 2021 and March 31, 2022 were identified using the state's pediatric COVID-19 registry. Delta and Omicron-infected patients without previous COVID-19 infection, COVID-19 vaccination, or co-infections were propensity-score matched 1:1 to control for differences in baseline characteristics. Clinical manifestations, treatments, and outcomes were analyzed. Disease severity was assessed using an adapted WHO ordinal scale.

Results: Of the initial 1367 patients, 668 had Delta infection and 699 had Omicron infection. Propensity-score matching produced 558 matched pairs. Patients with Omicron infection were more likely to present with croup (the odds ratio, OR, was 10.87, with a 95% confidence interval, CI, ranging from 2.54 to 46.59), lower respiratory tract infection (OR 2.32, 95% CI, 1.48-3.64) and seizures (OR 8.39, 95% CI, 5.04-13.99) compared with those with Delta infection. Omicron was associated with increased odds of moderate/severe disease (OR 6.14, 95% CI, 4.72-7.99) and a greater need for intravenous fluid therapy (OR 6.00, 95% CI, 4.29-8.39), corticosteroids (OR 3.08, 95% CI, 1.66-5.72), empirical antibiotics (OR 1.70, 95% CI, 1.10-2.64), and low-flow nasal oxygen therapy (OR 3.68, 95% CI, 2.17-6.22) in comparison with Delta.

Conclusion: Children hospitalized with Omicron infection demonstrated a distinct clinical profile compared to those with Delta infection, with increased likelihood of moderate/severe disease and higher utilization of health-care resources.

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来源期刊
Pediatrics International
Pediatrics International 医学-小儿科
CiteScore
2.00
自引率
7.10%
发文量
519
审稿时长
12 months
期刊介绍: Publishing articles of scientific excellence in pediatrics and child health delivery, Pediatrics International aims to encourage those involved in the research, practice and delivery of child health to share their experiences, ideas and achievements. Formerly Acta Paediatrica Japonica, the change in name in 1999 to Pediatrics International, reflects the Journal''s international status both in readership and contributions (approximately 45% of articles published are from non-Japanese authors). The Editors continue their strong commitment to the sharing of scientific information for the benefit of children everywhere. Pediatrics International opens the door to all authors throughout the world. Manuscripts are judged by two experts solely upon the basis of their contribution of original data, original ideas and their presentation.
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