新型冠状病毒Omicron变异株感染患儿的临床特征及免疫效应分析

Clinical characteristics and vaccination status of SARS-CoV-2 Omicron variant infected children

目的探究新型冠状病毒Omicron变异株感染患儿的临床特征及免疫效应情况。方法回顾性分析2022年1月8日至2月3日于天津市海河医院(天津市新型冠状病毒感染患儿定点医院)住院的105例感染新型冠状病毒Omicron变异株患儿的临床资料,按胸部影像学表现分为肺炎组和无肺炎组,入院3 d后完成新型冠状病毒抗体检测的患儿按是否接种2剂次新型冠状病毒疫苗分为接种2剂次组和接种<2剂次组,组间比较采用秩和检验或χ^(2)检验。结果105例新型冠状病毒Omicron变异株感染患儿中男53例、女52例,就诊年龄10.0(8.0,11.0)岁,87例(82.9%)为轻型,13例(12.4%)为普通型,5例(4.8%)为无症状感染者。91例(86.7%)患儿已接种2剂次新型冠状病毒灭活疫苗。常见的临床症状为咳嗽74例(70.5%)、发热58例(55.2%)、咽痛或咽干34例(32.4%)、鼻塞28例(26.7%)、流涕23例(21.9%)。105例患儿均未用抗病毒、激素、免疫抑制剂及吸氧治疗,76例(72.4%)患儿使用中药治疗。肺炎组入院1 d内新型冠状病毒抗体IgG阳性比例明显高于无肺炎组[13/13比87.0%(80/92),χ^(2)=42.81,P<0.001]。62例入院3 d后完成新型冠状病毒抗体检测患儿中接种2剂次组发病至连续2次核酸阴性时间<16 d、入院1 d内新型冠状病毒抗体IgG阳性及住院3 d后新型冠状病毒抗体IgG阳性的比例均高于接种<2剂次组[96.4%(54/56)比4/6、100.0%(56/56)比2/6、100.0%(56/56)比3/6,均P<0.05]。结论新型冠状病毒Omicron变异株感染患儿症状较轻,以呼吸道感染症状为主。完成接种2剂次新型冠状病毒灭活疫苗患儿的新型冠状病毒抗体IgG阳性比例高且核酸转阴时间可能更短。

Objective To investigate the clinical characteristics and vaccination status of SARS-CoV-2 Omicron variant infected children.Methods A total of 105 children infected with Omicron variant admitted to Tianjin Haihe Hospital(designated referral hospital for SARS-CoV-2 infection in Tianjin)from January 8,2022 to February 3 were included for a retrospective study.The cases were divided into pneumonia group and non-pneumonia group according to chest imaging.Based on the doses of inactivated SARS-CoV-2 vaccine,the children who completed SARS-CoV-2 antibody test within 3 days after hospitalization were divided into 2-dose group and<2-dose group.Rank sum test and Chi-square test were used for the comparison between the groups.Results The age of these 105 children was 10.0(8.0,11.0)years on admission,53 children were males and 52 were females.Eighty-seven cases(82.9%)had mild symptoms,13 cases(12.4%)had common symptoms and 5 cases(4.8%)were asymptomatic.Ninety-one cases(86.7%)completed 2 doses vaccination.The clinical symptoms were characterized by cough(74 cases,70.5%),fever(58 cases,55.2%),sore or dry throat(34 cases,32.4%),nasal congestion(28 cases,26.7%),rhinorrhea(23 cases,21.9%).None of the children received antivirals,steroids,immunosuppressant or oxygen therapy.Seventy-six cases(72.4%)received traditional Chinese medicine treatment.The pneumonia group had a higher rate of positive SARS-CoV-2 IgG within 1 day after admission(13/13 vs.87.0%(80/92),χ2=42.81,P<0.001)than the non-pneumonia group.Among the 62 children who had serial SARS-CoV-2 antibody tests within 3 days after hospitalization,Compared to the<2-dose group,the 2-dose group had a higher rate of nucleic acid conversion within 16 days after onset and a higher rate of positive SARS-CoV-2 IgG 1 day after admission and 3 days after hospitalization(96.4%(54/56)vs.4/6,100.0%(56/56)vs.2/6,100.0%(56/56)vs.3/6,all P<0.05).Conclusions Most children infected with Omicron variant have mild symptoms,mainly respiratory infection symptoms.The proportion of SARS-CoV-2 antibody IgG positive in children who have received 2 doses of inactivated SARS-CoV-2 vaccines is higher,and the time of whose nucleic acid conversion may be shortened.