接种新型冠状病毒灭活疫苗后感染Delta变异株的新型冠状病毒肺炎患儿临床特征分析

Clinical features of children with coronavirus disease 2019 Delta variant infection after vaccination with inactivated SARS-CoV-2 vaccine

目的通过比较接种/未接种新型冠状病毒灭活疫苗(简称新冠疫苗)后感染新型冠状病毒Delta变异株的新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)患儿的临床特征,为儿童COVID-19的临床诊疗提供参考。方法将2021年11月3日至12月17日河南省定点救治医院收治的接种新冠疫苗后感染新型冠状病毒Delta变异株的COVID-19患儿11例纳入接种疫苗组,同期住院的未接种新冠疫苗感染新型冠状病毒Delta变异株的COVID-19患儿31例纳入未接种疫苗组,回顾性收集两组患儿的流行病学、临床特征及实验室检查资料进行比较。结果两组患儿性别构成和疾病分型比较差异均无统计学意义(P>0.05)。咳嗽、咳痰、发热等临床症状发生率在两组间比较差异均无统计学意义(P>0.05)。白细胞计数、淋巴细胞百分比、丙氨酸氨基转移酶水平、血肌酐水平升高发生率在两组间比较差异均无统计学意义(P>0.05)。接种疫苗组患儿天冬氨酸氨基转移酶、乳酸脱氢酶、肌酸激酶同工酶水平明显低于未接种疫苗组(P<0.05)。两组患儿C反应蛋白、降钙素原水平增高发生率及外周血细胞因子水平比较差异均无统计学意义(P>0.05)。接种疫苗组患儿B淋巴细胞和总T淋巴细胞(CD3+)计数低于未接种疫苗组(P<0.05)。接种疫苗组患儿在入院时、病程第2周的IgG阳性率均高于未接种疫苗组(P<0.05)。在病程第1周、第2周接种疫苗组患儿新型冠状病毒核酸Ct值较未接种疫苗组增高(P<0.05)。结论接种新冠疫苗可能会减少新型冠状病毒Delta变异株对患儿心肌的损害,接种新冠疫苗后再感染新型冠状病毒Delta变异株的患儿,更需警惕其免疫功能受损。

Objective To study the clinical features of children with coronavirus disease 2019(COVID-19)Delta variant infection vaccinated or not vaccinated with inactivated severe acute respiratory syndrome coronavirus 2(SARSCoV-2)vaccine.Methods A total of 11 children with COVID-19 Delta variant infection who were vaccinated with inactivated SARS-CoV-2 vaccine and were hospitalized in the designated hospital in Henan Province,China,from November 3 to December 17,2021 were enrolled as the vaccinated group.Thirty-one children with COVID-19 Delta variant infection who were not vaccinated and were hospitalized during the same period were enrolled as the unvaccinated group.A retrospective analysis was performed on their epidemiological data,clinical features,and laboratory examination results.Results There was no significant difference in gender composition and disease classification between the two groups(P>0.05),and there was also no significant difference in the incidence rates of the clinical symptoms such as cough,expectoration,and fever between the two groups(P>0.05).No significant difference was found between the two groups in leukocyte count,lymphocyte percentage,alanine aminotransferase,and serum creatinine(P>0.05).Compared with the unvaccinated group,the vaccinated group had significantly lower levels of aspartate aminotransferase,lactate dehydrogenase,and creatine kinase-MB(P<0.05).There was no significant difference between the two groups in the proportion of children with elevated C-reactive protein or procalcitonin and the levels of peripheral blood cytokines(P>0.05).The vaccinated group had significantly lower counts of B lymphocytes and total T lymphocytes(CD3+)than the unvaccinated group(P<0.05).Compared with the unvaccinated group,the vaccinated group had a significantly higher positive rate of IgG on admission and at week 2 of the course of disease(P<0.05),as well as a significantly higher Ct value of nucleic acid at weeks 1 and 2 of the course of disease(P<0.05).Conclusions Vaccination with inactivated SARS-CoV-2 vaccine may reduce myocardial injury caused by SARS-CoV-2 Delta variant.For children with SARS-CoV-2 Delta variant infection after the vaccination,more attention should be paid to their immune function.