造血干细胞移植术后儿童感染新型冠状病毒Omicron的临床特征分析

Clinical features of SARS-CoV-2 Omicron variant infection in children after hematopoietic stem cell transplantation

目的:探讨接受造血干细胞移植术后儿童与无基础疾病正常儿童感染新型冠状病毒Omicron(以下简称Omicron)后临床特征差异性。方法:回顾性分析2022年12月―2023年1月感染Omicron儿童的临床资料,将接受造血干细胞移植儿童81例纳入移植组,无基础疾病正常儿童507例纳入正常组,比较两组患儿临床特征上的差异。结果:移植组与正常组年龄性别均无统计学差异。两组感染Omicron后主要症状均表现为发热,移植组64例(79.0%)正常组389例(76.7%);其次为咳嗽,移植组57例(70.4%)正常组306例(60.4%),两组发热和咳嗽症状比较均无统计学意义。同时移植组出现高热(34.6%vs 36.7%)、呼吸困难(4.9%vs 2.8%)、鼻塞(43.2%vs 46.5%)、咽痛(35.8%vs 28.4%)与正常组差异均无统计学意义。但移植组出现胃肠道不适(50.6%vs 27.2%)、败血症(3.7%vs 0.2%)、须使用呼吸支持治疗(3.7%vs 0%)、总病程超过2周(43.2%vs 10.1%)均明显高于正常组。结论:移植组和正常组患儿感染Omicron后均以轻型为主,但移植患儿中型或以上较严重感染比正常儿童更高,且病程更长。接受造血干细胞移植术后的感染患儿仍须积极预防重症感染及严重不良事件的发生。

Objective To investigate the difference of clinical features between children who received hematopoietic stem cell transplantation and normal children without underlying diseases infected with Omicron variant of SARS-CoV-2(hereinafter referred to as Omicron).Methods Clinical data on Omicron-infected children from 2022-12-01 to 2023-1-20 were analyzed retrospectively.Eighty-one children who had received hematopoietic stem cell transplants were included in the transplant group,and 507 normal children without underlying medical conditions were included in the normal group.The differences in clinical characteristics between the two groups were compared.Results There were no significant differences in age or gender between the transplant group and the normal group.The main symptom of Omicron infection in both groups was fever,64 cases(79.0%)in the transplantation group compared with 389 cases(76.7%)in the normal group.The second most common symptom was cough,57 cases(70.4%)in the transplantation group were compared with 306 cases(60.4%)in the normal group.There was no statistical significance in fever and cough symptoms between the two groups.At the same time,there were no significant differences between the transplantation group and the normal group in high fever(34.6%vs 36.7%),dyspnea(4.9%vs 2.8%),nasal congestion(43.2%vs 46.5%),and sore throat(35.8%vs 28.4%).In addition,gastrointestinal discomfort(50.6%vs 27.2%),sepsis(3.7%vs 0.2%),respiratory support(3.7%vs 0%),and total disease duration over 2 weeks(43.2%vs 10.1%)in the transplant group were significantly higher than those in the normal group.Conclusion Omicron infection was mainly mild in both the transplant and normal groups,but the incidence of moderate to severe infection was higher in the transplant group than in the normal group,and the duration of the disease was longer.Infected children following hematopoietic stem cell transplantation should still be actively prevented from serious infections and serious adverse events.