过敏性疾病患儿感染新型冠状病毒Omicron变异株的临床特征

Clinical characteristics of children infected with SARS-CoV-2 Omicron variant combined with allergic disease

目的探讨过敏性疾病患儿感染新型冠状病毒Omicron变异株的临床特征。方法横断面研究。选取2022年4月25日至6月8日上海交通大学医学院附属儿童医院确诊新型冠状病毒感染的43例过敏性疾病患儿为过敏性疾病组, 同期确诊的114例无基础疾病的患儿为无基础疾病对照组(简称无基础疾病组), 16例合并其他基础疾病的患儿为有基础疾病对照组(简称其他基础疾病组)。收集并分析各组患儿的临床表现特点、实验室检查、住院时间和新型冠状病毒核酸转阴时间等资料, 组间比较采用Kruskal-WallisH检验、χ^(2)检验或Fisher确切概率法。结果 43例过敏性疾病组患儿中男28例、女15例, 就诊年龄为4.4(2.1, 8.2)岁, 其中轻型32例、普通型11例。过敏性疾病包括特应性皮炎或湿疹20例(46.5%)、鼻炎14例(32.6%)、食物过敏8例(18.6%)、哮喘7例(16.3%)、过敏性结膜炎4例(9.3%)、药物过敏2例(4.7%)。114例无基础疾病组患儿中男57例、女57例, 就诊年龄为2.8(1.2, 5.6)岁, 其中轻型93例、普通型21例。16例其他基础疾病组患儿中男9例、女7例, 就诊年龄为3.0(2.6, 10.8)岁, 其中轻型13例、普通型3例。过敏性疾病组患儿的咽痛、呕吐发生比例均高于无基础疾病组[10例(23.3%)比9例(7.9%)、14例(32.6%)比11例(9.6%), χ^(2)=6.93、12.24, 均P<0.05], 淋巴细胞计数低于无基础疾病组[1.1(0.7, 1.7)×10^(9)比1.6(1.1, 2.7)×10^(9)/L, H=-28.00, P=0.005]。3组患儿在就诊年龄、性别、新型冠状病毒感染分型、新型冠状病毒PCR的循环阈值、住院时间及新型冠状病毒核酸转阴时间方面差异均无统计学意义(均P>0.05)。结论过敏性疾病患儿感染新型冠状病毒Omicron变异株临床特征多为咽痛和呕吐, 过敏性疾病几乎不影响儿童新型冠状病毒感染的病程。

Objective To investigate the clinical characteristics of children with allergic diseases suffering from SARS-CoV-2 Omicron variant strains.Methods This was a cross-sectional study.A total of 43 pediatric patients with allergic diseases infected by SARS-CoV-2 from April 25,2022 to June 8,2022 in Shanghai Jiao Tong University School of Medicine were selected as the allergic disease group,while 114 cases without underlying diseases and 16 cases with other underlying diseases were selected as control groups diagnosed at the same period.Clinical data including clinical features,laboratory tests,duration of hospitalization,and the time to negative turn of novel coronavirus nucleic acid were collected and analysed.Kruskal-Wallis H test,chi-square test or Fisher exact test were used for comparison among three groups.Results Among the 43 patients with allergic diseases,28 were males and 15 were females,with an age of 4.4(2.1,8.2)years on admission,including 32 mild cases and 11 common cases.The allergic disease group included 20 cases(46.5%)of atopic dermatitis and eczema,followed by 14 cases(32.6%)of rhinitis,8 cases(18.6%)of food allergies,7 cases(16.3%)of asthma,4 cases(9.3%)of allergic conjunctivitis and 2 cases(4.7%)of drug allergy.Among the 114 cases without underlying diseases,57 were males and 57 were females,with an age of 2.8(1.2,5.6)years on admission,including 93 mild cases and 21 common cases.Among the 16 cases with other underlying diseases,9 were males and 7 were females,with an age of 3.0(2.6,10.8)years on admission,including 13 cases mild and 3 cases common cases.Children with allergic diseases had higher frequency of sore throat and vomiting than those without underlying diseases(10 cases(23.3%)vs.9 cases(7.9%),14 cases(32.6%)vs.11 cases(9.6%),χ²=6.93,12.24,both P<0.05).The lymphocyte count of patients with allergic disease was lower than those without underlying disease(1.1(0.7,1.7)×10^(9)vs.1.6(1.1,2.7)×10^(9)/L,H=-28.00,P=0.005).There were no significant differences in age,gender,typing of SARS-CoV-2,the duration of hospitalization,cycle threshold values of SARS-CoV-2 and the time to negative turn of novel coronavirus nucleic acid among the three groups(all P>0.05).Conclusions Children with allergic diseases may suffer from sore throat and vomiting more frequently when infected with SARS-CoV-2 Omicron variant.The combination of allergic diseases hardly influenced the disease course of SARS-CoV-2 in children.