新生儿社区获得性新型冠状病毒奥密克戎变异株感染7例临床分析

Clinical analysis of 7 cases of community-acquired Novel Coronavirus Omicron variant infection in neonates

目的探讨新生儿社区获得性新型冠状病毒奥密克戎变异株感染后的临床特点。方法选择2022年上海疫情期间上海交通大学医学院附属上海儿童医学中心隔离病房收治的社区获得性新型冠状病毒奥密克戎变异株感染的新生儿病例进行回顾性研究,分析其流行病学特点、临床表现及转归。结果共收治社区获得性新型冠状病毒奥密克戎变异株感染新生儿7例,男3例,女4例,均为足月儿,均有明确的接触史,感染途径源于生活密切接触的照护者(父母或月嫂)。临床症状以上呼吸道感染为主,发热6例,鼻塞6例,咳嗽5例,流涕2例,纳差2例,腹泻1例。入院时血常规白细胞计数正常或减少、C反应蛋白未见异常,血清淀粉样蛋白A除1例升高外余未见异常;胸部X线片未见明显异常。患儿入院后均予单间隔离,常规对症处理,定期复查核酸,首次转阴时间中位数为起病后的17 d(8~26 d),连续2次(间隔24 h)核酸检测CT值≥35后出院居家健康监测。出院后4~6周随访,5例患儿出院时有鼻塞,其中2例伴有咳嗽,均渐愈,无其他不适表现,所有患儿核酸检测无复阳。结论社区获得性新型冠状病毒奥密克戎变异株感染的7例新生儿均有明确的接触史,临床症状以上呼吸道感染为主,持续时间较长,新冠病毒核酸转阴所需时间相对较长,但短期预后总体良好。

Objective To study the clinical characteristics of neonatal community-acquired Novel Coronavirus(COVID-19)Omicron variant infection.Methods From March 30 to May 15,2022,the epidemiological characteristics,clinical manifestations and outcomes of neonatal cases of community-acquired COVID-19 Omicron variant infection admitted to the isolation ward of our hospital were analyzed.Results A total of 7 neonates infected with community-acquired COVID-19 Omicron variant were treated,including 3 males and 4 females.All of them were term infants with clear epidemiological exposure history.The infection was originated from caregivers of close contact(parents or babysitters).The main clinical symptoms was upper respiratory tract infection,including fever(6 cases),nasal congestion(6 cases),cough(5 cases),runny nose(2 cases),poor appetite(2 cases)and diarrhea(1 case).On admission,no abnormalities were found in blood routine examination and C-reactive protein(CRP).All but one case had normal serum amyloid A(SAA).No obvious abnormalities were found on chest X-ray.All patients were isolated in single-patient rooms after admission.They received standard symptomatic treatment and regular nucleic acid tests.The first negative nucleic acid results came on median 17 d(8~26 d)after the onset of the disease.The patients were discharged after two consecutive(24 h apart)nucleic acid tests with CT value≥35 and continued health-monitor at home.On discharge,5 patients had nasal congestion and 2 of them had cough.During the follow-up 4~6 weeks after discharge,all patients gradually recovered without positive nucleic acid results.Conclusions All 7 neonates with community-acquired COVID-19 Omicron variant infection have epidemiological exposure history.The main clinical symptoms are long-lasting upper respiratory tract infections.It takes a relatively long time for the nucleic acid to turn negative,however,the overall short-term prognosis is good.