合并基础疾病儿童感染新型冠状病毒Omicron变异株的临床特征分析  

Clinical characteristics of the SARS-CoV-2 Omicron variant infection in children with different basic diseases

作　　者：王静[1] 周媛婕 邓小霞 沈楠 王薇[1] Wang Jing;Zhou Yuanjie;Deng Xiaoxia;Shen Nan;Wang Wei(Department of Infectious Diseases,Shanghai Children′s Medical Center,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属上海儿童医学中心感染科,200127

出　　处：《中国小儿急救医学》2022年第10期779-783,共5页Chinese Pediatric Emergency Medicine

基　　金：上海交通大学医工(理)交叉基金资助(ZH2018QNA28)。

摘　　要：目的探讨合并基础疾病的儿童感染新型冠状病毒Omicron变异株BA.2.2后的临床特征。方法回顾性分析2022年3月2日至6月10日上海交通大学医学院附属上海儿童医学中心收治的76例确诊新型冠状病毒感染且合并基础疾病患儿的临床表现、辅助检查、治疗及预后等。按合并疾病种类分为血液肿瘤组、非血液肿瘤组, 非血液肿瘤组患儿包括心肺疾病组、神经系统疾病组、先天性畸形组, 分析不同种类基础疾病患儿感染新型冠状病毒Omicron变异株后的临床特征及预后。结果 76例合并基础疾病儿童中, 初诊发热者61例、无症状者15例, 合并血液肿瘤疾病、心肺疾病、神经系统疾病、先天性畸形患儿分别为26例、22例、20例、8例;4种基础疾病患儿发热时间3~7 d, 合并咳嗽、鼻塞、流涕、呕吐、腹泻等表现较少, 肺部影像学表现轻, 无一例重症肺炎发生, 各疾病组临床表现无明显差异(P>0.05)。血液肿瘤组患儿更易发生单脏器或多脏器功能不全, C-反应蛋白水平较非血液肿瘤组升高, 白细胞计数、中性粒细胞计数、淋巴细胞计数、血红蛋白较非血液肿瘤组降低, 病毒转阴时间、发热持续时间高于非血液肿瘤组, 差异均有统计学意义(P均<0.05)。血液肿瘤组患儿中, 2周内进行化疗感染新型冠状病毒后的患儿血象、炎症指标较非化疗组更差, 发热持续时间、病毒转阴时间更长(P<0.05), 其中3例血液肿瘤患儿病毒转阴后, 在进行化疗及手术治疗后出现复阳。结论新型冠状病毒Omicron变异株BA.2.2对合并心肺疾病、神经系统疾病、先天性畸形患儿未造成严重影响, 但可导致血液肿瘤患儿发热持续时间及病毒转阴时间延长, 其中化疗后患儿较未化疗患儿所受影响更大, 这对血液肿瘤患儿疫情防控策略制定及化疗时机选择产生重要影响。Objective To investigate the clinical characteristics of SARS-CoV-2 Omicron variant BA.2.2 infection in children with different basic diseases.Methods A total of 76 children with different basic diseases admitted to Shanghai Children′s Medical Center,Shanghai Jiao Tong University School of Medicine from March 2 to June 10,2022 were retrospectively analyzed in terms of clinical manifestations,supplementary examination,treatment and prognosis.These children were divided into hematologic tumor group and non-hematologic tumor group which included cardiopulmonary disease group,neurological disease group and congenital malformation group.The clinical characteristics and prognosis of SARS-CoV-2 Omicron variant infection in children with basic diseases were analyzed.Results Among 76 children with basic diseases,61 patients were newly diagnosed with fever and 15 patients were asymptomatic.There were 26,22,20,and 8 cases with hematologic tumor diseases,cardiopulmonary diseases,neurological diseases and congenital malformation,respectively.The average fever time was 3-7 days.There was no significant difference in the clinical manifestations among each group(P>0.05).However,children with hematological tumors were more prone to single organ or multiple organ dysfunction.The level of C-reactive protein was higher than that in the non-hematologic tumor group,while the white blood cell count,neutrophil count,lymphocyte count and hemoglobin were lower than those in the non-hematologic tumor group.The time of virus negative transformation and the duration of fever were higher than those in the non-hematologic tumor group,with statistical significance(P<0.05).Among the children in the hematologic tumor group,the blood routine and inflammation indexes of children infected with SARS-CoV-2 after chemotherapy within 2 weeks were worse than those in the non-chemotherapy group,and the duration of fever and the time of virus negative transformation were significantly longer(P<0.05).Three children with hematologic tumor showed virus posi

关 键 词：新型冠状病毒 Omicron变异株 基础疾病 血液肿瘤疾病 

分 类 号：R725.6[医药卫生—儿科]