新型冠状病毒肺炎疫情期间儿童病毒性腹泻常见病原体变化  

Changes of common pathogens of viral diarrhea in children during the COVID-19 epidemic

作　　者：楼金玕[1] 李伟[2] 彭克荣[1] 赵泓[1] 吕垚 彭朝阳[2] 楼月 陈洁[1] Lou Jingan;Li Wei;Peng Kerong;Zhao Hong;Lyu Yao;Peng Chaoyang;Lou Yue;Chen Jie(Department of Gastroenterology,the Children’s Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,Hangzhou 310052,Zhejiang Province,China;Clinical Laboratory,the Children’s Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,Hangzhou 310052,Zhejiang Province,China)

机构地区：[1]浙江大学医学院附属儿童医院,国家儿童健康与疾病临床医学研究中心消化内科,杭州310052 [2]浙江大学医学院附属儿童医院,国家儿童健康与疾病临床医学研究中心实验检验中心,杭州310052

出　　处：《中华临床感染病杂志》2022年第4期264-268,共5页Chinese Journal of Clinical Infectious Diseases

基　　金：浙江省科技厅重点研发项目(2019C03037);浙江省公益项目(LGC21H200004);浙江省自然科学基金(LQ22H160006)。

摘　　要：目的比较儿童病毒性腹泻常见病原体在新型冠状病毒肺炎疫情(新冠疫情)期间的变化。方法回顾性分析2019年4月1日至12月31日(新冠疫情前)407例和2020年4月1日至12月31日(新冠疫情期间)645例在浙江大学医学院附属儿童医院就诊的急性腹泻患儿的资料,将所有研究对象分为1~6月、>6月~2岁和>2~5岁年龄组,采用χ^(2)或Fisher精确检验比较不同年龄段、不同季节新冠疫情前和疫情期间诺如病毒GI型(NOVI)、诺如病毒GⅡ型(NOVⅡ)、轮状病毒A组(ROVA)、轮状病毒C组(ROVC)、肠道腺病毒(EADV)、沙波病毒(SAV)和星状病毒(ASV)的检出率。结果新冠疫情前不同年龄段腹泻患儿病毒总检出率高于新冠疫情期间(χ^(2)=8.43、38.22和9.23,P值均<0.05),且在1~6月和>6月~2岁婴幼儿中,NOVⅡ和EADV检出率在新冠疫情期间有所降低(χ^(2)_(NOVⅡ)=36.87和17.77,P值均<0.001,χ^(2)_(EADV)=9.08,P=0.014和0.003)。在>2~5岁患儿中,NOVⅡ检出率在新冠疫情期间有所降低(χ^(2)=3.96,P=0.047),其他病毒检出率在新冠疫情期间无明显降低(P值均>0.05)。4~6月、7~9月、10~12月常见病毒检出率均高于新冠疫情期间的检出率(χ^(2)=11.62、65.41和27.80,P值均<0.001)。结论新冠疫情发生后,儿童病毒性腹泻常见病原体检出率下降,特别是NOVⅡ和EADV,可能与浙江省启动重大公共卫生事件响应有关。Objective To analyze the changes of common pathogens of viral diarrhea in children during the COVID-19 epidemic.Methods A retrospective analysis was performed on children with acute diarrhea treated in Children’s Hospital affiliated to Zhejiang University School of Medicine from 2019 April to 2019 December(before COVID-19,n=407)and 2020 April to 2020 December(during COVID-19,n=645).Children were further divided into 1-6 months,>6 months-2 years,>2-5 years age groups.Detection rates of norovirus GI(NOVI),norovirus GⅡ(NOVⅡ),rotavirus A(ROVA),rotavirus C(ROVC),intestinal adenovirus(EADV),sapovirus(SAV)and astrovirus(ASV)in different age groups and seasons before and during COVID-19 were compared byχ^(2) or Fisher exact test.Results The total detection rates of diarrhea-causing viruses among age groups were significantly higher before COVID-19 than those during COVID-19(χ^(2)=8.43,38.22 and 9.23,all P<0.05).The detection rates of NOVⅡand EADV in infants aged 1-6 months and>6 months-2 years were decreased during the period of COVID-19 epidemic(χ^(2)_(NOVⅡ)=36.87 and 17.77,both P<0.001,χ^(2)_(EADV)=9.08,P=0.014 and 0.003);the detection rates of NOVⅡin children aged 2-5 years was decreased during the period of COVID-19 epidemic(χ^(2)=3.96,P=0.047);the detection rates of other diarrhea-causing viruses were not decreased during the period of COVID-19 epidemic(all P>0.05).The detection rates of diarrhea-causing viruses among 4-6 months,7-9 months and 10-12 months were higher during the period of COVID-19 epidemic(χ^(2)=11.62,65.41 and 27.80,all P<0.001).Conclusion After the outbreak of COVID-19,the detection rate of common pathogens of viral diarrhea in children is decreased,especially NOVⅡand EADV,which may be related to the measures in response to major public health events in Zhejiang Province.

关 键 词：新型冠状病毒肺炎 病毒性腹泻 儿童 诺如病毒 轮状病毒 

分 类 号：R725.1[医药卫生—儿科] R446.5[医药卫生—临床医学]