影响Omicron变异株感染轻型和普通型COVID-19患儿核酸转阴时间缩短因素分析  

Analysis of influencing factors of shortened time of viral nucleic acid negative conversion in mild and common COVID-19 children infected with Omicron variant strain

作　　者：秦凤 丁博[1] 陈轶维[2] 周建国 张婷[4] 俞蕙 王立波 周文浩 卢燕鸣[1] Feng Qin;Bo Ding;Yiwei Chen;Jianguo Zhou;Ting Zhang;Hui Yu;Libo Wang;Wenhao Zhou;Yanming Lu(Department of Pediatrics,Renji Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 201124,China;Department of Cardiology,National Children′s Medical Center/Shanghai Children′s Medical Center,School of Medicine,Shanghai Jiao Tong University,Shanghai 200127,China;Department of Neonatology,National Children′s Medical Center/Children′s Hospital of Fudan University,Shanghai 201102,China;Department of Gastroenterology,Children′s Hospital of Shanghai,Children′s Hospital Affiliated to School of Medicine,Shanghai Jiao Tong University,Shanghai 200062,China;Department of Infectious Diseases,National Children′s Medical Center/Children′s Hospital of Fudan University,Shanghai 201102,China;Department of Respiratory,National Children′s Medical Center/Children′s Hospital of Fudan University,Shanghai 201102,China)

机构地区：[1]上海交通大学医学院附属仁济医院儿科,上海201124 [2]国家儿童医学中心/上海交通大学医学院附属上海儿童医学中心心内科,上海200127 [3]国家儿童医学中心/复旦大学附属儿科医院新生儿科,上海201102 [4]上海市儿童医院/上海交通大学医学院附属儿童医院消化科,上海200062 [5]国家儿童医学中心/复旦大学附属儿科医院感染传染科,上海201102 [6]国家儿童医学中心/复旦大学附属儿科医院呼吸科,上海201102

出　　处：《中华妇幼临床医学杂志（电子版）》2022年第6期669-676,共8页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

摘　　要：目的探讨Omicron变异株感染轻型与普通型新型冠状病毒疾病(COVID-19)患儿的临床特征及影响其核酸检测结果转为阴性(以下简称为"核酸转阴")时间缩短因素。方法选取2022年4月7日至5月20日上海交通大学医学院附属仁济医院南院区"亲子病房"集中收治的150例Omicron变异株感染轻型和普通型COVID-19患儿为研究对象。采用回顾性分析方法,根据这150例患儿的核酸转阴中位时间为13 d,将其分别纳入快转阴组(n=84,核酸转阴时间<13 d)和慢转阴组(n=66,核酸转阴时间≥13 d)。对2组患儿年龄、性别、轻型与普通型COVID-19患儿构成比、疫苗接种率、COVID-19相关临床表现及COVID-19发病48 h内系统炎症指数(SII)、中性粒细胞与淋巴细胞比值(NLR)、淋巴细胞与单核细胞比值(LMR)、血小板与淋巴细胞比值(PLR)等,进行成组t检验、Mann-Whitney U检验或χ2检验。采用多因素非条件logistic回归分析方法,分析影响Omicron变异株感染轻型与普通型COVID-19患儿核酸转阴时间缩短的因素。2组患儿合并基础疾病占比、采取对症治疗率等一般临床资料分别比较,差异均无统计学意义(P>0.05)。本研究遵循的程序符合2013修订的《世界医学协会赫尔辛基宣言》要求。结果①快转阴组患儿年龄、女性患儿比例、普通型COVID-19患儿比例、疫苗接种率,发热、咽痛、胃肠道症状发生率,均显著高于慢转阴组,而热峰、肌肉酸痛发生率,则均显著低于慢转阴组,2组比较,差异均有统计学意义(P<0.05)。②多因素非条件logistic回归分析结果显示,伴有咽痛、接种疫苗是轻型与普通型COVID-19患儿核酸转阴时间缩短的独立保护因素(OR=14.609、7.866,95%CI:1.108~192.697、1.313~47.121,P=0.042、0.024),而伴有肌肉酸痛、男性患儿则是其独立危险因素(OR=0.275、0.206,95%CI:0.087~0.874、0.083~0.511,P=0.029、0.001)。③快转阴组患儿SII为250.9×109/L(111.1×109/L,466.9×109/L),NLR�Objective To investigate the clinical features of mild and common corona virus disease 2019(COVID-19)children infected with Omicron variant,and influencing factor of shortened time of nucleic acid negative conversion.Methods A total of 150 mild and common COVID-19 children infected with Omicron variant in the"parent-child ward"of the southern area of Renji Hospital,School of Medicine,Shanghai Jiao Tong University from April 7 to May 20,2022 were selected as research subjects.According to the median time of nucleic acid negative conversion(13 d),these 150 children were included in fast turning negative group(n=84,time of nucleic acid negative conversion<13 d)and slow turning negative group(n=66,time of nucleic acid negative conversion≥13 d).Independent-samples t test,Mann-Whitney U test or chi-square test were performed for comparison between two groups,such as age,gender,composition ratio of mild and common COVID-19,vaccination rate,clinical manifestations related to COVID-19,and systemic immune-inflammation index(SII),neutrophil-to-lymphocyte ratio(NLR),lymphocyte-to-monocyte ratio(LMR),platelet-to-lymphocyte ratio(PLR)within 48 h of COVID-19 onset.Analysis of influencing factors of shortened time of nucleic acid negative conversion in mild and common COVID-19 children infected with Omicron variant was conducted by multivariate unconditional logistic regression analysis.There was no statistically significant difference between two groups in the proportion of children with basic diseases and the rate of symptomatic treatment(P>0.05).The procedures followed in this study were in accordance with the Helsinki Declaration of the World Medical Association revised in 2013.Results①The age,proportion of female children,proportion of children with common type of COVID-19,vaccination rate,incidence of fever,sore throat and gastrointestinal symptoms in fast turning negative group were significantly higher than those in slow turning negative group,while the heat peak and incidence of muscle soreness were significantly lo

关 键 词：严重急性呼吸综合征冠状病毒2 新型冠状病毒疾病 疫苗接种 Omicron株 病毒 核酸转阴 外周血参数比值 儿童 

分 类 号：R725.1[医药卫生—儿科]