儿童新型冠状病毒肺炎核酸转阴时间的影响因素分析  

Related factors of negative conversion time of nucleic acid in children with COVID-19

作　　者：李玉峰[1] 张建华 干晗[3] 张开创 蔡康[5] 刘巍 雒胜男 蒋红丽[8] 金彪[9] 赵列宾[10] 孙锟[6] Li Yufeng;Zhang Jianhua;Gan Han;Zhang Kaichuang;Cai Kang;Liu Wei;Luo Shengnan;Jiang Hongli;Jin Biao;Zhao Liebin;Sun Kun(Department of Pediatric Nephrology,Rheumatology and Immunology,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China;Department of Pediatric Pulmonology,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China;Department of Anesthesiology and Surgical Intensive Care Unit,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China;Department of Pediatric Endocrinology and Genetic Metabolism,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China;Department of Infectious Diseases,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China;Department of Pediatric Heart Center,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China;Jinglang Senior Expert Clinic,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China;Department of Cardiology,Changxing Branch of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 201913,China;Department of Radiology,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China;Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属新华医院儿肾脏风湿免疫科,上海200092 [2]上海交通大学医学院附属新华医院儿呼吸内科,上海200092 [3]上海交通大学医学院附属新华医院麻醉与重症医学科,上海200092 [4]上海交通大学医学院附属新华医院儿内分泌遗传代谢科,上海200092 [5]上海交通大学医学院附属新华医院感染科,上海200092 [6]上海交通大学医学院附属新华医院儿心脏中心,上海200092 [7]上海交通大学医学院附属新华医院镜朗高级专家诊疗部,上海200092 [8]上海交通大学医学院附属新华医院长兴分院心血管内科,上海201913 [9]上海交通大学医学院附属新华医院放射科,上海200092 [10]上海交通大学医学院附属新华医院,上海200092

出　　处：《中华儿科杂志》2023年第3期256-260,共5页Chinese Journal of Pediatrics

摘　　要：目的分析影响儿童新型冠状病毒肺炎核酸转阴时间的相关因素。方法回顾性队列研究。收集2022年4月3日至5月31日于上海交通大学医学院附属新华医院长兴分院(上海市新型冠状病毒肺炎患儿定点救治医院)因确诊新型冠状病毒肺炎住院的225例患儿的确诊年龄、性别、病毒载量、基础疾病、临床症状以及陪护人员信息等资料。根据患儿胸部影像学表现分为轻型组和普通型组,按确诊年龄将患儿分为<3岁组和3~<18岁组,根据陪护人员核酸检测结果将患儿分为阳性陪护组和阴性陪护组。组间比较采用Mann-Whitney U检验、χ^(2)检验,采用Logistic回归分析影响儿童新型冠状病毒肺炎核酸转阴时间的相关因素。结果225例患儿中男120例、女105例,感染年龄2.8(1.3,6.2)岁,<3岁119例、3~<18岁106例。普通型19例、轻型206例。阳性陪护组患儿141例、阴性陪护组84例。3~<18岁组患儿新型冠状病毒核酸转阴时间短于<3岁组[5(3,7)比7(4,9)d,Z=-4.17,P<0.001]。阴性陪护组患儿核酸转阴的时间短于阳性陪护组[5(3,7)比6(4,9)d,Z=-2.89,P=0.004]。临床症状Logistic回归分析发现纳差与核酸转阴时间有相关性(OR=3.74,95%CI 1.69~8.31,P=0.001)。结论陪护人员同时感染新型冠状病毒可能延长新型冠状病毒肺炎患儿的核酸转阴时间。新型冠状病毒肺炎患儿纳差影响核酸转阴时间。Objective To explore the related factors of negative conversion time(NCT)of nucleic acid in children with COVID-19.Methods A retrospective cohort study was conducted.A total of 225 children who were diagnosed with COVID-19 and admitted to Changxing Branch of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from April 3^(rd) to May 31^(st) 2022 were enrolled in the study.The infection age,gender,viral load,basic disease,clinical symptoms and information of accompanying caregivers were retrospectively analyzed.According to age,the children were divided into<3 years of age group and 3-<18 years of age group.According to the viral nucleic acid test results,the children were divided into positive accompanying caregiver group and negative accompanying caregiver group.Comparisons between groups were performed using Mann-Whitney U test or Chi-square test.Multivariate Logistic regression analysis was used to analyze the related factors of NCT of nucleic acid in children with COVID-19.Results Among the 225 patients(120 boys and 105 girls)of age 2.8(1.3,6.2)years,119 children<3 years and 106 children 3-<18 years of age,19 cases were diagnosed with moderate COVID-19,and the other 206 cases were diagnosed with mild COVID-19.There were 141 patients in the positive accompanying caregiver group and 84 patients in the negative accompanying caregiver group.Patients 3-<18 years of age had a shorter NCT(5(3,7)vs.7(4,9)d,Z=-4.17,P<0.001)compared with patients<3 years of age.Patients in the negative accompanying caregiver group had a shorter NCT(5(3,7)vs.6(4,9)d,Z=-2.89,P=0.004)compared with patients in the positive accompanying caregiver group.Multivariate Logistic regression analysis showed that anorexia was associated with NCT of nucleic acid(OR=3.74,95%CI 1.69-8.31,P=0.001).Conclusion Accompanying caregiver with positive nucleic acid test may prolong NCT of nucleic acid,and decreased appetite may be associated with prolonged NCT of nucleic acid in children with COVID-19.

关 键 词：儿童 新型冠状病毒 Omicron株 因素分析 监护 

分 类 号：R725.1[医药卫生—儿科]