Severe Acute Respiratory Syndrome Coronavirus 2 Infections Among Children in the Biospecimens from Respiratory Virus-Exposed Kids (BRAVE Kids) Study.
Severe Acute Respiratory Syndrome Coronavirus 2 Infections Among Children in the Biospecimens from Respiratory Virus-Exposed Kids (BRAVE Kids) Study.
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DOI：
10.1093/cid/ciaa1693
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发表时间：
2021-11-02
期刊：
影响因子：
--
通讯作者：
Kelly MS
中科院分区：
文献类型：
--
作者：
Hurst JH;Heston SM;Chambers HN;Cunningham HM;Price MJ;Suarez L;Crew CG;Bose S;Aquino JN;Carr ST;Griffin SM;Smith SH;Jenkins K;Pfeiffer TS;Rodriguez J;DeMarco CT;De Naeyer NA;Gurley TC;Louzao R;Zhao C;Cunningham CK;Steinbach WJ;Denny TN;Lugo DJ;Moody MA;Permar SR;Rotta AT;Turner NA;Walter EB;Woods CW;Kelly MS
患有严重急性呼吸综合征冠状病毒2 （SARS-CoV-2）感染的儿童通常症状轻微，不需要就医，这给我们对该病毒在儿童中引起的SARS-CoV-2相关疾病的了解留下了空白。我们对sars - cov -2感染密切接触者的儿童和青少年（年龄<21岁）进行了前瞻性队列研究。我们在入组时收集鼻咽拭子或鼻拭子，并使用实时聚合酶链反应法检测SARS-CoV-2。在382名儿童中，293名（77%）感染了sars - cov -2。与未感染的儿童相比，感染sars - cov -2的儿童更有可能是西班牙裔（P < 0.0001），患哮喘的可能性更低（P = 0.005），与感染的兄弟姐妹接触的可能性更大（P = 0.001）。6-13岁的儿童经常无症状（39%），呼吸道症状的发生率低于年龄较小的儿童（29%对48%，P = 0.01）或青少年（29%对60%，P < 0.001）。与6-13岁的儿童相比，青少年更频繁地报告流感样（61%对39%，P < 0.001）、胃肠道（27%对9%，P = 0.002）和感觉症状（42%对9%，P < 0.001），并且疾病持续时间更长（中位数[四分位数间距]持续时间：7[4-12]天和4[3-8]天，P = 0.01）。尽管症状与年龄相关，但我们发现鼻咽病毒载量在年龄或有症状和无症状儿童之间没有差异。西班牙裔和受感染的兄弟姐妹密切接触者与儿童感染SARS-CoV-2的风险增加有关，而哮喘与风险降低有关。在评估2019年冠状病毒病儿童以及制定学校和托儿机构筛查策略时，必须考虑SARS-CoV-2感染临床表现的年龄相关差异。西班牙裔和感染SARS-CoV-2的兄弟姐妹是感染SARS-CoV-2的危险因素。与其他年龄组相比，6-13岁的儿童更常无症状。病毒载量没有因年龄或临床表现而异。
Child with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection typically have mild symptoms that do not require medical attention, leaving a gap in our understanding of the spectrum of SARS-CoV-2-related illnesses that the viruses causes in children. We conducted a prospective cohort study of children and adolescents (aged <21 years) with a SARS-CoV-2-infected close contact. We collected nasopharyngeal or nasal swabs at enrollment and tested for SARS-CoV-2 using a real-time polymerase chain reaction assay. Of 382 children, 293 (77%) were SARS-CoV-2-infected. SARS-CoV-2-infected children were more likely to be Hispanic (P < .0001), less likely to have asthma (P = .005), and more likely to have an infected sibling contact (P = .001) than uninfected children. Children aged 6-13 years were frequently asymptomatic (39%) and had respiratory symptoms less often than younger children (29% vs 48%; P = .01) or adolescents (29% vs 60%; P < .001). Compared with children aged 6-13 years, adolescents more frequently reported influenza-like (61% vs 39%; P < .001) , and gastrointestinal (27% vs 9%; P = .002), and sensory symptoms (42% vs 9%; P < .0001) and had more prolonged illnesses (median [interquartile range] duration: 7 [4-12] vs 4 [3-8] days; P = 0.01). Despite the age-related variability in symptoms, wWe found no difference in nasopharyngeal viral load by age or between symptomatic and asymptomatic children. Hispanic ethnicity and an infected sibling close contact are associated with increased SARS-CoV-2 infection risk among children, while asthma is associated with decreased risk. Age-related differences in clinical manifestations of SARS-CoV-2 infection must be considered when evaluating children for coronavirus disease 2019 and in developing screening strategies for schools and childcare settings. Hispanic ethnicity and a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected sibling were SARS-CoV-2 infection risk factors. Children aged 6-13 years were more frequently asymptomatic compared with other age groups. Viral loads did not differ by age or clinical presentation.
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