血液恶性肿瘤患儿感染 SARS-CoV-2 的临床特征和预后：中国多中心回顾性研究。

IF 2.3 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology Pub Date : 2024-11-01 DOI:10.1016/j.pedneo.2023.12.006

Weilin Wang , Xueju Xu , Songting Bai , Lu Wang , Jixia Luo , Daiyan Zhao , Ping Li , Qiuxia Fan , Chunmei Wang , Qianghua Yao , Bai Li , Dao Wang

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引用次数: 0

摘要

背景：血液恶性肿瘤（HM）患儿感染SARS-CoV-2的数据有限。在此，我们描述了血液恶性肿瘤患儿感染 SARS-CoV-2 后的临床特征，并研究了导致疾病严重程度的潜在危险因素：方法：回顾性纳入2022年10月至2023年1月期间中国河南五市五家医院的HM和SARS-CoV-2感染患儿。收集临床信息和2019年冠状病毒病（COVID-19）疫苗接种情况，以便进一步分析：结果：共纳入285名感染HM和SARS-CoV-2的儿童。3.2%的患者（9人）无症状，89.1%（254人）为轻度，5.3%（15人）为中度，1.8%（5人）为重度，0.7%（2人）为危重。发热（92.4%）和咳嗽（56.9%）是最常见的症状。大多数患儿（249人，88.3%）在COVID-19发病期间在家接受治疗。在入院的 36 名儿童中，2 名需要重症监护室护理，11 名需要补充氧气，2 名需要无创通气。共有 283 名（99.3%）儿童完全康复，2 名（0.7%）儿童死于 COVID-19。在多变量分析中，合并症（OR，10.4；95%CI，2.8-38.7；P）是导致感染严重程度增加的重要风险因素：与普通儿科人群相比，患有 HM 的儿童感染严重 COVID-19 的风险并没有增加。然而，淋巴细胞减少症和中性粒细胞减少症等合并症可能会增加患中度或重度/危重疾病的风险。我们的数据可能有助于为这一易感人群做出管理决策。

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Clinical characteristics and prognosis of SARS-CoV-2 infection in children with hematological malignancies: A multicenter, retrospective study in China

Background

Data on SARSCoV-2 infection in children with hematological malignancies (HM) are limited. Here, we describe the clinical features of children with HM after SARS-CoV-2 infection and investigate the potential risk factors for disease severity.

Methods

Children with HM and SARS-CoV-2 infection from five hospitals in five cities in Henan, China from October 2022 to January 2023 were retrospectively included. Clinical information and Coronavirus disease 2019 (COVID-19) vaccination status were collected for further analyses.

Results

A total of 285 children with HM and SARS-CoV-2 infections were included. COVID-19 was asymptomatic in 3.2% of the patients (n = 9), mild in 89.1% (n = 254), moderate in 5.3% (n = 15), severe in 1.8% (n = 5), and critical in 0.7% (n = 2). Fever (92.4%) and cough (56.9%) were the most common symptoms. Most (249, 88.3%) children were managed at home during their COVID-19 illness. Of the 36 children admitted to the hospital, two required intensive care unit care, 11 required supplementary oxygen, and two non-invasive ventilation. A total of 283 (99.3%) children fully recovered and two (0.7%) died due to COVID-19. Significant risk factors for increased severity of infection in multivariable analyses were the presence of comorbidity (OR, 10.4; 95%CI, 2.8–38.7; p < 0.0001), neutropenia (OR, 10.4; 95%CI, 2.6–41.8; p = 0.001), and lymphopenia (OR, 4.2; 95%CI, 1.2–15.4; p = 0.029). A total of 30.9% (88/285) of the children received at least one dose of the inactivated COVID-19 vaccine at COVID-19 diagnosis. Compared with children who received at least one dose of the COVID-19 vaccine, fever was significantly more common in unvaccinated children (79.3% vs. 93.8%, p < 0.001).

Conclusions

Children with HM are not at an increased risk of severe COVID-19 compared to the general pediatric population. However, comorbidities such as lymphopenia and neutropenia may increase the risk of developing moderate or severe/critical disease. Our data may help in management decisions for this vulnerable population.

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来源期刊

Pediatrics and Neonatology PEDIATRICS-

CiteScore

3.10

自引率

0.00%

发文量

170

审稿时长

48 days

期刊介绍： Pediatrics and Neonatology is the official peer-reviewed publication of the Taiwan Pediatric Association and The Society of Neonatology ROC, and is indexed in EMBASE and SCOPUS. Articles on clinical and laboratory research in pediatrics and related fields are eligible for consideration.