Severe Acute Respiratory Syndrome Coronavirus 2 Clinical Syndromes and Predictors of Disease Severity in Hospitalized Children and Youth.
Severe Acute Respiratory Syndrome Coronavirus 2 Clinical Syndromes and Predictors of Disease Severity in Hospitalized Children and Youth.
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重症急性呼吸综合征冠状病毒2住院儿童和青少年的临床综合征和疾病严重程度的预测因素
DOI：
10.1016/j.jpeds.2020.11.016
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Tri-State Pediatric COVID-19 Research Consortium
中科院分区：
文献类型：
--
作者：
Fernandes DM;Oliveira CR;Guerguis S;Eisenberg R;Choi J;Kim M;Abdelhemid A;Agha R;Agarwal S;Aschner JL;Avner JR;Ballance C;Bock J;Bhavsar SM;Campbell M;Clouser KN;Gesner M;Goldman DL;Hammerschlag MR;Hymes S;Howard A;Jung HJ;Kohlhoff S;Kojaoghlanian T;Lewis R;Nachman S;Naganathan S;Paintsil E;Pall H;Sy S;Wadowski S;Zirinsky E;Cabana MD;Herold BC;Tri-State Pediatric COVID-19 Research Consortium
描述儿童严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)综合征的人口学和临床特征，并确定预测疾病严重程度的入院变量。我们在纽约、新泽西和康涅狄格州的8个地点对因急性SARS-CoV-2感染和儿童多系统炎症综合征(MIS-C)住院的儿童患者进行了一项多中心、回顾性和前瞻性研究。我们鉴定了281例SARS-CoV-2感染的住院患者，并根据临床特征将其分为3组。总体而言，143人(51%)有呼吸道疾病，69人(25%)有MISC，69人(25%)有其他症状，包括胃肠道疾病或发烧。与患有呼吸系统疾病的患者相比，患有MIS-C的患者更有可能认同为非西班牙裔黑人(35%比18%，P=2.02)。7名患者(2%)死亡，114名(41%)患者进入重症监护病房。在多变量分析中，肥胖(OR 3.39，95%CI 1.26~9.10，P=2.02)和入院时低氧(OR 4.01；95%CI 1.14~14.15；P=5.03)是严重呼吸道疾病的预测因素。较低的淋巴细胞绝对计数(OR 8.33/109个淋巴细胞/L，95%可信区间2.32~33.33，P=0.001)和较高的C反应蛋白(OR 1.06/dL，95%可信区间1.01~1.12，P=0.017)是严重的MIS-C的预测因素。种族/民族或社会经济地位不能预测疾病的严重程度。我们确定了住院时的变量，这些变量可能有助于预测儿童和青少年严重SARS-CoV-2疾病表现的发展。这些变量可能会对未来的预后工具产生影响，为入院和临床管理提供信息。
To characterize the demographic and clinical features of pediatric severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) syndromes and identify admission variables predictive of disease severity. We conducted a multicenter, retrospective, and prospective study of pediatric patients hospitalized with acute SARS-CoV-2 infections and multisystem inflammatory syndrome in children (MIS-C) at 8 sites in New York, New Jersey, and Connecticut. We identified 281 hospitalized patients with SARS-CoV-2 infections and divided them into 3 groups based on clinical features. Overall, 143 (51%) had respiratory disease, 69 (25%) had MIS-C, and 69 (25%) had other manifestations including gastrointestinal illness or fever. Patients with MIS-C were more likely to identify as non-Hispanic black compared with patients with respiratory disease (35% vs 18%, P = .02). Seven patients (2%) died and 114 (41%) were admitted to the intensive care unit. In multivariable analyses, obesity (OR 3.39, 95% CI 1.26-9.10, P = .02) and hypoxia on admission (OR 4.01; 95% CI 1.14-14.15; P = .03) were predictive of severe respiratory disease. Lower absolute lymphocyte count (OR 8.33 per unit decrease in 109 cells/L, 95% CI 2.32-33.33, P = .001) and greater C-reactive protein (OR 1.06 per unit increase in mg/dL, 95% CI 1.01-1.12, P = .017) were predictive of severe MIS-C. Race/ethnicity or socioeconomic status were not predictive of disease severity. We identified variables at the time of hospitalization that may help predict the development of severe SARS-CoV-2 disease manifestations in children and youth. These variables may have implications for future prognostic tools that inform hospital admission and clinical management.
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作者：
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通讯作者：
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DOI：
10.1177/0046958016667596
发表时间：
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