上海380例家庭聚集性感染Omicron变异株的儿童及其家属临床特征分析

Clinical features of children and their family members with family clusters of SARS-CoV-2 Omicron variant infection in Shanghai, China: an analysis of 380 cases

目的 分析亲子病房收治模式下,家庭聚集性感染Omicron变异株的儿童及其家属的临床特点及转归。方法 回顾性收集上海市第六人民医院新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)定点医院于2022年4月8日至5月10日收治确诊的感染Omicron变异株患儿190例及其家属190例的临床资料,进行分析总结。结果 儿童组和成人组均以轻型为主,儿童组轻型比例高于成人组(P<0.05);2组临床表现均以上呼吸道症状为主,儿童组发热、腹痛腹泻、喘息发生率高于成人组(P<0.05),鼻塞流涕咳嗽、咽干咽痒咽痛发生率低于成人组(P<0.05);成人组治疗连花清瘟颗粒/小儿豉翘清热颗粒、中药汤剂、重组人干扰素α2b喷雾剂、止咳化痰药、奈玛特韦/利托那韦片使用率均高于儿童组(P<0.05);儿童组疫苗接种率(30.5%)较成人组(71.1%)低(P<0.001),而儿童组严重急性呼吸综合征冠状病毒2 (severe acute respiratory syndrome coronavirus 2,SARSCoV-2)核酸阳性持续时间短于成人组(P<0.05)。2组临床轻型者SARS-CoV-2核酸阳性持续时间短于普通型者(P<0.05)。2组有基础疾病者SARS-CoV-2核酸阳性持续时间长于无基础疾病者(P<0.05)。结论 家庭聚集性Omicron变异株感染儿童和成人的临床分型均以轻型为主。尽管儿童疫苗接种率较低,但在亲子病房收治模式中,疾病恢复较快,SARS-CoV-2核酸阳性持续时间短于成人。

Objective To study the clinical features and prognosis of children and their family members with family clusters of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) Omicron variant infection under the admission mode of parent-child ward.Methods A retrospective analysis was performed on the medical data of 190 children and 190 family members with SARS-CoV-2 Omicron variant infection who were admitted to Shanghai Sixth People’s Hospital,the designated hospital for coronavirus disease 2019(COVID-19),April 8 to May 10,2022.Results Both the child and adult groups were mainly mild COVID-19,and the proportion of mild cases in the child group was higher than that in the adult group(P<0.05).Respiratory symptoms were the main clinical manifestations in both groups.Compared with the adult group,the child group had higher incidence rates of fever,abdominal pain,diarrhea,and wheezing(P<0.05) and lower incidence rates of nasal obstruction,runny nose,cough,dry throat,throat itching,and throat pain(P<0.05).Compared with the child group,the adult group had higher rates of use of Chinese patent drugs,traditional Chinese medicine decoction,recombinant interferon spray,cough-relieving and phlegm-eliminating drugs,and nirmatrelvir/ritonavir tablets(P<0.05).Compared with the adult group,the child group had a lower vaccination rate of SARS-CoV-2 vaccine(30.5% vs 71.1%,P<0.001) and a shorter duration of positive SARS-CoV-2 nucleic acid(P<0.05).The patients with mild COVID-19 had a shorter duration of positive SARS-CoV-2 nucleic acid than those with common COVID-19 in both groups(P<0.05).The patients with underlying diseases had a longer duration of positive SARS-CoV-2 nucleic acid than those without such diseases in both groups(P<0.05).Conclusions Both children and adults with family clusters of SARS-CoV-2 Omicron variant infection manifest mainly mild COVID-19.Despite lower vaccination rate of SARS-CoV-2 vaccine in children,they have rapid disease recovery,with a shorter duration of positive SARS-CoV-2 nucleic acid than adults,under the admission mode of parent-child ward.