目的 探讨儿童Delta变异株新型冠状病毒肺炎（coronavirus disease 2019，COVID-19）的流行病学及临床特征，分析其与儿童普通COVID-19的差异。 方法 回顾性选取2021年8~9月确诊的Delta变异株COVID-19和2020年2~3月确诊COVID-19的14岁以下儿童16例为研究对象。将16例患儿按照病毒变异情况分为变异组（n=11）与普通组（n=5），对两组流行病学、临床特征及实验室检查资料进行比较。 结果 临床症状发生比例在变异组与普通组间比较差异无统计学意义（P>0.05）。白细胞计数、淋巴细胞计数和血小板计数在两组间比较差异无统计学意义（P>0.05）；变异组中性粒细胞计数低于普通组（P<0.05）；两组均没有淋巴细胞减少病例。变异组肌酸激酶同工酶增高比例较普通组多见（P<0.05）；而乳酸脱氢酶、D-二聚体、C-反应蛋白、白细胞介素-6增高比例与普通组比较差异无统计学意义（P>0.05）。9例变异组患儿在入院第2周有5例检测出IgM抗体阳性，均检测出IgG抗体阳性；入院第3周9例患儿IgM抗体水平呈下降趋势，8例患儿IgG抗体水平呈下降趋势。 结论 Delta变异株感染性增强，对儿童心肌的损害高于普通COVID-19。儿童感染Delta变异株后，IgG抗体出现时间与IgM抗体基本相同。
Abstract
Objective To study the epidemiological and clinical features of children with coronavirus disease 2019 (COVID-19) caused by Delta variant infection and their differences from children with ordinary COVID-19 (non-Delta variant infection). Methods Eleven children aged <14 years, who were diagnosed with COVID-19 caused by Delta variant infection from August to September 2021 were enrolled (variant group). Five children aged <14 years who were diagnosed with ordinary COVID-19 from February to March 2020 served as the control group. The epidemiological data, clinical features, and laboratory examination results were compared between the two groups. Results There was no significant difference in the proportion of children with clinical symptoms between the two groups (P>0.05). There were no significant differences in white blood cell count, lymphocyte count, and platelet count between the two groups (P>0.05), while the variant group had a lower neutrophil count than the control group (P<0.05). Lymphocytopenia was not observed in either group. Compared with the control group, the variant group had a higher proportion of children with an increase in creatine kinase isoenzyme (P<0.05), while there were no significant differences in the proportion of children with an increase in lactate dehydrogenase, D-Dimer, C-reactive protein or interleukin-6 between the two groups (P>0.05). Among the 9 children in the variant group, 5 tested positive for IgM antibody at week 2 after admission, and all children tested positive for IgG antibody. At week 3 after admission, the level of IgM antibody tended to decrease in 9 children, and the level of IgG antibody tended to decrease in 8 children. Conclusions Delta variant is more infectious. COVID-19 caused by Delta variant infection may cause more serious myocardial damage than ordinary COVID-19 in children. In children infected with Delta variant, IgG antibody appears at almost the same time as IgM antibody.
关键词
COVID-19 /
Delta变异株 /
临床特征 /
儿童
Key words
COVID-19 /
Delta variant /
Clinical feature /
Child
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