不同年龄段儿童Delta变异株感染所致新型冠状病毒感染的临床特征分析  

Clinical features of children with coronavirus disease 2019 caused by Delta variant infection in different age groups

作　　者：苏杭[1,2] 段凤阳[1,2] 任献青[1,2] 张霞[1,2] 闫永彬 SU Hang;DUAN Feng-Yang;REN Xian-Qing;ZHANG Xia;YAN Yong-Bin(Department of Pediatrics,First Affiliated Hospital of Henan University of Traditional Chinese Medicine/College of Pediatrics,Henan University of Traditional Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学第一附属医院儿科,河南郑州450000 [2]河南中医药大学儿科医学院,河南郑州450000

出　　处：《中国当代儿科杂志》2023年第3期289-294,共6页Chinese Journal of Contemporary Pediatrics

基　　金：国家中医药管理局新型冠状病毒感染肺炎中医药应急专项(2022ZYLCYJ01-2);河南省中医药科学研究专项课题(2022ZYZD03)。

摘　　要：目的 分析不同年龄段儿童Delta变异株感染所致新型冠状病毒感染患儿的临床特征,为儿童新型冠状病毒感染的临床诊疗提供参考。方法 将2021年11月17日-12月17日河南省定点救治医院收治的Delta变异株感染所致的新型冠状病毒感染患儿45例分为3组(<6岁组16例,6~13岁组16例,>13岁组13例),比较3组患儿的临床特征及实验室检查结果。结果 各年龄组均以轻型病例为主,均以咳嗽、咳痰为主要临床表现,发热仅在6~13岁组中出现。<6岁组血清天冬氨酸氨基转移酶、乳酸脱氢酶、肌酸激酶同工酶水平高于其他两组(P<0.05)。6~13岁组血肌酐水平升高患儿比例最高,达50%。仅>13岁组中4例患儿出现血清C反应蛋白增高。在3个年龄组中,6~13岁组外周血CD3+CD4+淋巴细胞、CD3+CD8+淋巴细胞及自然杀伤细胞计数均最低。>13岁组入院时SARS-CoV-2 IgG阳性率高于其他两组(P<0.05)。3组患儿胸部CT影像学表现差异无统计学意义(P>0.05)。结论 不同年龄段患儿Delta变异株感染所致的新型冠状病毒感染的临床特征可能存在差异:<6岁患儿可能更易出现心肌损害;6~13岁患儿除出现咳嗽、咳痰等临床症状外,还可出现发热,且可能更易发生肾功能及免疫功能损害。Objective To study the clinical features of children with coronavirus disease 2019(COVID-19) caused by Delta variant infection in different ages groups.Methods A total of 45 children with COVID-19 caused by Delta variant infection who were hospitalized in the designated hospital in Henan Province,China,from November 17 to December 17,2021,were included.They were divided into three groups:<6 years group(n=16),6-13 years group(n=16),and >13 years group(n=13).The three groups were compared in clinical features and laboratory examination data.Results COVID-19 in all age groups was mainly mild.Main manifestations included cough and expectoration in the three groups,and fever was only observed in the 6-13 years group.The <6 years group had significantly higher serum levels of aspartate aminotransferase,lactate dehydrogenase,and creatine kinase isoenzymes than the other two groups(P<0.05).The 6-13 years group had the highest proportion of children with elevated serum creatinine levels(50%).Among the three groups,only 4 children in the >13 years group had an increase in serum C-reactive protein levels.The 6-13 years group had the lowest counts of CD3+CD4+lymphocytes,CD3+CD8+lymphocytes,and natural killer cells in the peripheral blood among the three groups.The >13 years group had a significantly higher positive rate of SARS-Co V-2 IgG on admission than the other two groups(P<0.05).There was no significant difference in the imaging findings on chest CT among the three groups(P>0.05).Conclusions The clinical features of COVID-19 caused by Delta variant infection in children of different age groups may be different:children aged <6 years tend to develop myocardial injury,and those aged 6-13 years have fever except cough and expectoration and tend to develop renal and immune dysfunction.

关 键 词：新型冠状病毒感染 Delta变异株 临床特征 儿童 

分 类 号：R563.1[医药卫生—呼吸系统]