不同年龄段儿童Delta变异株感染所致新型冠状病毒感染的临床特征分析

Clinical features of children with coronavirus disease 2019 caused by Delta variant infection in different age groups

摘要:

目的 分析不同年龄段儿童Delta变异株感染所致新型冠状病毒感染患儿的临床特征，为儿童新型冠状病毒感染的临床诊疗提供参考。方法 将2021年11月17日—12月17日河南省定点救治医院收治的Delta变异株感染所致的新型冠状病毒感染患儿45例分为3组（<6岁组16例，6~13岁组16例，>13岁组13例），比较3组患儿的临床特征及实验室检查结果。结果 各年龄组均以轻型病例为主，均以咳嗽、咳痰为主要临床表现，发热仅在6~13岁组中出现。<6岁组血清天冬氨酸氨基转移酶、乳酸脱氢酶、肌酸激酶同工酶水平高于其他两组（P<0.05）。6~13岁组血肌酐水平升高患儿比例最高，达50%。仅>13岁组中4例患儿出现血清C反应蛋白增高。在3个年龄组中，6~13岁组外周血CD3⁺CD4⁺ 淋巴细胞、CD3⁺CD8⁺ 淋巴细胞及自然杀伤细胞计数均最低。>13岁组入院时SARS-CoV-2 IgG阳性率高于其他两组（P<0.05）。3组患儿胸部CT影像学表现差异无统计学意义（P>0.05）。结论 不同年龄段患儿Delta变异株感染所致的新型冠状病毒感染的临床特征可能存在差异：<6岁患儿可能更易出现心肌损害；6~13岁患儿除出现咳嗽、咳痰等临床症状外，还可出现发热，且可能更易发生肾功能及免疫功能损害。

Abstract:

Objective To study the clinical features of children with coronavirus disease 2019 (COVID-19) caused by Delta variant infection in different ages groups.Methods A total of 45 children with COVID-19 caused by Delta variant infection who were hospitalized in the designated hospital in Henan Province, China, from November 17 to December 17, 2021, were included. They were divided into three groups: <6 years group (n=16), 6-13 years group (n=16), and >13 years group (n=13). The three groups were compared in clinical features and laboratory examination data.Results COVID-19 in all age groups was mainly mild. Main manifestations included cough and expectoration in the three groups, and fever was only observed in the 6-13 years group. The <6 years group had significantly higher serum levels of aspartate aminotransferase, lactate dehydrogenase, and creatine kinase isoenzymes than the other two groups (P<0.05). The 6-13 years group had the highest proportion of children with elevated serum creatinine levels (50%). Among the three groups, only 4 children in the >13 years group had an increase in serum C-reactive protein levels. The 6-13 years group had the lowest counts of CD3⁺CD4⁺ lymphocytes, CD3⁺CD8⁺ lymphocytes, and natural killer cells in the peripheral blood among the three groups. The >13 years group had a significantly higher positive rate of SARS-CoV-2 IgG on admission than the other two groups (P<0.05). There was no significant difference in the imaging findings on chest CT among the three groups (P>0.05).Conclusions The clinical features of COVID-19 caused by Delta variant infection in children of different age groups may be different: children aged <6 years tend to develop myocardial injury, and those aged 6-13 years have fever except cough and expectoration and tend to develop renal and immune dysfunction.