奥密克戎变异株感染所致新型冠状病毒感染疾病新生儿的临床特征分析

Clinical characteristics of neonates infected with the Omicron variant of severe acute respiratory syndrome coronavirus 2

目的探讨奥密克戎(Omicron)变异株流行期间,Omicron感染所致新型冠状病毒感染疾病(COVID-19)新生儿的临床特征。方法选择2022年12月20日至2023年1月16日四川大学华西第二医院新生儿隔离病房收治的63例Omicron变异株感染所致COVID-19新生儿的临床资料为研究对象。回顾性分析其流行病学史、临床表现、实验室检查、影像学表现、治疗及转归等临床特征。本研究遵循的程序符合四川大学华西第二医院伦理委员会规定,通过该医院伦理委员会的审批与同意(审批文号:2022-069)。结果对本组63例Omicron变异株感染所致COVID-19新生儿的临床分析结果如下。①一般临床资料:男性患儿为30例,女性为33例;84.1%(53/63)患儿有与Omicron变异株确诊或疑似患者的密切接触史;COVID-19新生儿的临床分型为轻/中型者占比为76.2%(48/63),4.8%(3/63)为重型,19.0%(12/63)为无症状感染者;主要表现为发热(65.1%,41/63),呼吸系统症状(63.5%,40/63),消化系统症状(46.0%,29/63)。②实验室检查:外周血白细胞计数、C反应蛋白(CRP)、降钙素原(PCT)正常占比分别为79.4%(50/63)、88.9%(56/63)和91.1%(41/45)。③影像学检查:36例(75%,36/48)患儿X射线胸片及8例患儿胸部CT检查,均提示有肺炎征象。④治疗及转归:对63例患儿均采取对症支持治疗,5例患儿采取呼吸支持治疗后,所有患儿均治愈出院。结论本组Omicron变异株感染所致COVID-19新生儿以轻至中型为主,最常见的临床表现为发热,实验室检查结果无特异性,预后良好。Omicron变异株感染以水平传播途径为主,有效隔离措施可保护新生儿免受Omicron变异株感染。

Objective To explore the clinical characteristics of coronavirus disease 2019(COVID-19)neonates were infected by Omicron variant during the pandemic of Omicron variant.Methods A total of 63 COVID-19 neonates who infected by Omicron variant in the neonatal isolation ward of West China Second Hospital,Sichuan University from December 20,2022 to January 16,2023 were enrolled in this study.Their epidemiological history,clinical manifestations,laboratory examinations,imaging manifestations,treatment and outcome were retrospectively analyzed.The procedures followed in this study comply with the regulations of the Ethics Committee of West China Second University Hospital,Sichuan University,and have been approved by the Ethics Committee of the hospital(Approval No.2022-069).Results Among the 63 neonates,there were 30 boys and 33 girls.84.1%(53/63)of the cases had close contact history with confirmed or suspected cases of SARS-CoV-2 Omicron variant.In clinical classification,76.2%(48/63)were mild to moderate,4.8%(3/63)were severe,and 19.0%(12/63)were asymptomatic.The main manifestations of these neonates were fever(65.1%,41/63),respiratory symptoms(63.5%,40/63),and digestive symptoms(46.0%,29/63).The laboratory examination results showed that the normal proportions of peripheral blood white blood cell count,C-reactive protein,and procalcitonin(PCT)were 79.4%(50/63),88.9%(56/63),and 91.1%(41/45),respectively.Chest X-ray plain films of 36 cases(75.0%,36/48)and chest CT scans of 8 cases showed signs of pneumonia.And 63 cases were treated with symptomatic supportive therapy,and 5 cases were treated with respiratory support.All cases were cured and discharged.Conclusions Neonatal cases of SARS-CoV-2 Omicron variant infection is mainly mild to moderate,and the most common clinical manifestation is fever.Laboratory examination are non-specific.The prognosis of these cases is good.Horizontal transmission is the main of transmission route,and we should pay attention to the isolation of newborns during the pandemic.