目的 总结新生儿新型冠状病毒Omicron变异株感染病例的临床特点。 方法 回顾性分析2022年10—12月乌鲁木齐市第一人民医院城北院区收治的23例新型冠状病毒Omicron变异株感染新生儿的临床资料。 结果 23例患儿生后与新型冠状病毒感染确诊看护人有接触史，均非垂直传播。临床分型：无症状感染5例，轻型18例，无中型、重型及危重型病例。首发症状为发热13例，咳嗽3例，鼻塞1例，腹泻1例，同时多数病例存在一种或多种伴随症状。2例血白细胞计数减少，1例C反应蛋白增高。7例患儿因咳嗽或呼吸急促表现行胸部X线检查，提示其中1例局灶性渗出性改变，余未见异常改变。所有患儿对症治疗后均痊愈出院，住院时间中位数为6 d。N基因Ct值、ORF1ab基因Ct值与新型冠状病毒核酸持续阳性时间均呈负相关（rs分别为-0.719、-0.699，均P<0.05）。出院后1个月随访，均无症状复现及核酸复阳表现。 结论 新生儿新型冠状病毒Omicron变异株感染的临床表现通常为轻型或无症状型。新型冠状病毒核酸N和ORF1ab基因Ct值越低，核酸持续阳性时间越长。患儿经对症治疗后转归良好。
Abstract
Objective To summarize the clinical features of neonates infected with Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods The medical data of 23 neonates with Omicron variant of SARS-CoV-2 infection admitted to the City North Campus of Urumqi First People's Hospital from October to December 2022 were retrospectively reviewed. Results All 23 infants had a history of exposure to confirmed caregivers with SARS-CoV-2 infection after birth, and none of them was vertically transmitted. Clinical classification: 5 cases of asymptomatic infection, 18 cases of mild infection, and no cases of moderate, severe, or critically ill. The first symptoms were fever in 13 cases, cough in 3 cases, nasal congestion in 1 case, and diarrhea in 1 case. Blood white blood cell counts decreased in 2 cases, and C-reactive protein increased in 1 case. Seven infants underwent chest X-ray examination due to cough or shortness of breath, and one of which showed focal exudative changes, while the rest showed no abnormal changes. All infants were discharged after symptomatic treatment and the median hospital stay was 6 days. The duration of nucleic acid positivity of SARS-CoV-2 was negatively correlated with N gene Ct values and ORF1ab gene Ct values (rs=-0.719 and -0.699, respectively; P<0.05). One month after discharge, all infants had no symptoms or signs of nucleic acid re-positivity. Conclusions The clinical manifestations are usually mild or asymptomatic in neonates infected with SARS-CoV-2 Omicron variant. The lower the Ct values of the N and ORF1ab genes of SARS-CoV-2, the longer the duration of nucleic acid positivity. Neonates infected with SARS-CoV-2 Omicron variant can have a good prognosis after symptomatic treatment.
关键词
新型冠状病毒感染 /
Omicron变异株 /
水平传播 /
新生儿
Key words
Coronavirus disease 2019 /
Omicron variant /
Horizontal transmission /
Neonate
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
1 蒋荣猛, 谢正德, 姜毅, 等. 儿童新型冠状病毒感染诊断、治疗和预防专家共识(第五版)[J]. 中华实用儿科临床杂志, 2023, 38(1): 20-30. DOI: 10.3760/cma.j.cn101070-20230114-00036.
2 Pascarella S, Ciccozzi M, Bianchi M, et al. The electrostatic potential of the Omicron variant spike is higher than in Delta and Delta-plus variants: a hint to higher transmissibility?[J]. J Med Virol, 2022, 94(4): 1277-1280. PMID: 34914120. DOI: 10.1002/jmv.27528.
3 Pulliam JRC, van Schalkwyk C, Govender N, et al. Increased risk of SARS-CoV-2 reinfection associated with emergence of Omicron in South Africa[J]. Science, 2022, 376(6593): eabn4947. PMID: 35289632. PMCID: PMC8995029. DOI: 10.1126/science.abn4947.
4 张可, 蒋思远, 严恺, 等. 新型冠状病毒Omicron变异株流行期间新生儿感染16例临床特征分析[J]. 中华儿科杂志, 2022, 60(11): 1158-1162. PMID: 36319150. DOI: 10.3760/cma.j.cn112140-20220617-00561.
5 中华人民共和国国家卫生健康委员会. 新型冠状病毒感染诊疗方案(试行第十版)[J]. 中国合理用药探索, 2023, 20(1): 1-11. DOI: 10.3969/j.issn.2096-3327.2023.01.001.
6 Liotti FM, Menchinelli G, Marchetti S, et al. Assessment of SARS-CoV-2 RNA test results among patients who recovered from COVID-19 with prior negative results[J]. JAMA Intern Med, 2021, 181(5): 702-704. PMID: 33180119. PMCID: PMC7662488. DOI: 10.1001/jamainternmed.2020.7570.
7 Buonsenso D, Parri N, De Rose C, et al. Toward a clinically based classification of disease severity for paediatric COVID-19[J]. Lancet Infect Dis, 2021, 21(1): 22. PMID: 32422205. PMCID: PMC7228718. DOI: 10.1016/S1473-3099(20)30396-0.
8 中国当代儿科杂志编辑委员会围产新生儿新型冠状病毒感染防控管理预案工作组. 围产新生儿新型冠状病毒感染防控管理预案(第三版)[J]. 中国当代儿科杂志, 2023, 25(1): 1-4. PMID: 36655656. PMCID: PMC9893817. DOI: 10.7499/j.issn.1008-8830.2212074.
9 Salvatore CM, Han JY, Acker KP, et al. Neonatal management and outcomes during the COVID-19 pandemic: an observation cohort study[J]. Lancet Child Adolesc Health, 2020, 4(10): 721-727. PMID: 32711687. PMCID: PMC7377726. DOI: 10.1016/S2352-4642(20)30235-2.
10 Spoulou V, Noni M, Koukou D, et al. Clinical characteristics of COVID-19 in neonates and young infants[J]. Eur J Pediatr, 2021, 180(9): 3041-3045. PMID: 33786658. PMCID: PMC8009690. DOI: 10.1007/s00431-021-04042-x.
11 Trevisanuto D, Cavallin F, Cavicchiolo ME, et al. Coronavirus infection in neonates: a systematic review[J]. Arch Dis Child Fetal Neonatal Ed, 2021, 106(3): 330-335. PMID: 32943533. DOI: 10.1136/archdischild-2020-319837.
12 García H, Allende-López A, Morales-Ruíz P, et al. COVID-19 in neonates with positive RT-PCR test. Systematic review[J]. Arch Med Res, 2022, 53(3): 252-262. PMID: 35321802. PMCID: PMC8919773. DOI: 10.1016/j.arcmed.2022.03.001.
13 Akin IM, Kanburoglu MK, Tayman C, et al. Epidemiologic and clinical characteristics of neonates with late-onset COVID-19: 1-year data of Turkish Neonatal Society[J]. Eur J Pediatr, 2022, 181(5): 1933-1942. PMID: 35061093. PMCID: PMC8776552. DOI: 10.1007/s00431-021-04358-8.
14 Ciaglia E, Vecchione C, Puca AA. COVID-19 infection and circulating ACE2 levels: protective role in women and children[J]. Front Pediatr, 2020, 8: 206. PMID: 32391299. PMCID: PMC7192005. DOI: 10.3389/fped.2020.00206.
15 刘洁, 罗万军, 邓志宏, 等. 91例儿童新型冠状病毒肺炎确诊病例临床及流行病学特征[J]. 中华医院感染学杂志, 2020, 30(11): 1625-1629. DOI: 10.11816/cn.ni.2020-200550.
16 祁正红, 贝泽锋, 滕淑, 等. 杭州市19例新型冠状病毒Omicron变异株感染儿童的临床特征[J]. 中国当代儿科杂志, 2022, 24(10): 1092-1097. PMID: 36305108. PMCID: PMC9627995. DOI: 10.7499/j.issn.1008-8830.2205122.
17 Sun DW, Zhang D, Tian RH, et al. The underlying changes and predicting role of peripheral blood inflammatory cells in severe COVID-19 patients: a sentinel?[J]. Clin Chim Acta, 2020, 508: 122-129. PMID: 32417210. PMCID: PMC7224669. DOI: 10.1016/j.cca.2020.05.027.
18 Wang HJ, Xiang YH, Hu R, et al. Research progress in laboratory detection of SARS-CoV-2[J]. Ir J Med Sci, 2022, 191(2): 509-517. PMID: 33763777. PMCID: PMC7990494. DOI: 10.1007/s11845-021-02604-4.
PDF(517 KB)
