哺乳期母婴感染新型冠状病毒Omicron变异株的临床特征  

Clinical features of severe acute respiratory syndrome coronavirus-2 Omicron variant infection in mother-infant dyads during lactation

作　　者：卞相丽 国志 张坤 李妙晨 吴志敏 张金萍 Bian Xiangli;Guo Zhi;Zhang Kun;Li Miaochen;Wu Zhimin;Zhang Jinping(Department of Pediatrics,Shanghai Sixth People's Hospital,Shanghai 201306,China)

机构地区：[1]上海市第六人民医院儿科,上海201306

出　　处：《中华围产医学杂志》2022年第12期885-890,共6页Chinese Journal of Perinatal Medicine

基　　金：上海市第六人民医院2022年度抗击新型冠状病毒肺炎疫情应急专题项目(ynxg202213)。

摘　　要：目的:总结哺乳期母婴感染新型冠状病毒(简称新冠病毒)Omicron变异株的临床表现、病毒载量变化及转归。方法:回顾性纳入2022年4月8日至5月30日在上海市第六人民医院临港院区新冠病毒感染定点医院住院的婴儿1岁内的哺乳期母婴24对(哺乳组母亲、哺乳组婴儿),选择同期与哺乳组母亲临床分型和入院日期匹配的非哺乳组母亲(孩子1~3岁)24例作为对照。比较组间新冠病毒疫苗接种情况和每日的核酸开放阅读框1ab(open reading frame 1ab,ORF1ab)基因和核壳蛋白(nucleocapsid protein,N)基因的循环阈值(cycle threshold,Ct)以及核酸阳性持续时间。采用两独立样本t检验、单因素方差分析和LSD检验、χ^(2)检验进行统计学分析。结果:哺乳组婴儿月龄为(6.5±2.1)个月;新冠病毒Omicron变异株感染临床分型轻型23例,普通型1例;均未接种新冠病毒疫苗。哺乳组母亲与非哺乳组母亲年龄差异无统计学意义[(28.7±6.4)与(28.2±5.2)岁,t=0.30,P=0.768]。2组母亲中轻型病例均占88%(21/24),普通型占12%(3/24)。哺乳组母亲接种1剂新冠病毒疫苗3例,接种2剂疫苗2例;非哺乳组母亲接种1剂疫苗3例,接种2剂疫苗3例;2组母亲疫苗接种率差异无统计学意义[21%(5/24)与25%(6/24),χ^(2)=0.12,P=0.731]。哺乳组婴儿的主要症状依次为发热(100%,24/24)、腹泻(58%,14/24)、咳嗽(50%,12/24)和喘息(29%,7/24);哺乳组母亲的主要症状依次为发热(75%,18/24)、咳嗽(75%,18/24)和咽痛(63%,15/24);非哺乳组母亲的主要症状依次为咳嗽(88%,21/24)、咽痛(71%,17/24)和发热(58%,14/24)。核酸阳性持续时间在哺乳组婴儿[(9.2±2.1)d(5~14 d)]短于非哺乳组母亲[(11.2±2.4)d(6~16 d)]和哺乳组母亲[(14.0±4.2)d(8~26 d)],在非哺乳组母亲短于哺乳组母亲(LSD检验,P值均<0.05)。确诊第2~9天,每天哺乳组婴儿核酸Ct均高于哺乳组母亲和非哺乳组母亲(LSD检验,P值均<0.05);第10天婴儿组核酸Ct高于哺乳组母亲(ORF1ab�Objective To summarize the clinical features,viral load changes,and outcomes of severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)Omicron variant infection in mother-infant dyads during lactation period.Methods A total of 24 pairs of lactating mothers and infants under one year old who were infected with SARS-CoV-2 and hospitalized in Lingang Branch of Shanghai Sixth People's Hospital from April 8 to May 30,2022,were selected as the lactation group in this retrospective study.Another 24 non-lactating mothers,with children of one to three years old,who matched with those mothers in the lactation group in clinical classification and admission date were selected as the control group.Vaccination status,clinical symptoms,daily cycle threshold(Ct)of open reading frame 1ab(ORF1ab)gene and nucleocapsid protein(N)gene,and the duration of positive nucleic acid test were compared between the groups and were analyzed using two independent samples t test,one-way analysis of variance,LSD test,and Chi-square test.Results Among the 24 infants in the lactation group with an age of(6.5±2.1)months,23 cases were mild type,one was common,and none had been vaccinated against SARS-CoV-2.The maternal age of the lactation and the control group did not differ statistically[(28.7±6.4)vs(28.2±5.2)years,t=0.30,P=0.768].Mothers with mild type accounted for 88%(21/24)and those with common for 12%(3/24)in both groups of mothers.Three mothers received one dose of vaccine and two received two in the lactation group,while three received one dose and three received two in the control group[21%(5/24)vs 25%(6/24),χ^(2)=0.12,P=0.731].The most common symptoms of lactating infants were fever(100%,24/24),followed by diarrhea(58%,14/24),cough(50%,12/24),and wheeze(29%,7/24),those of the lactating mothers were fever(75%,18/24),cough(75%,18/24),and sore throat(63%,15/24),while those of non-lactating mothers were cough(88%,21/24),sore throat(71%,17/24),and fever(58%,14/24).The duration of positive nucleic acid test was the shortest in the lactat

关 键 词：新型冠状病毒 病毒载量 新型冠状病毒肺炎 传染性疾病传播 垂直 母乳喂养 

分 类 号：R725.1[医药卫生—儿科] R511[医药卫生—临床医学]