Preliminary evidence on long COVID in children
Preliminary evidence on long COVID in children
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DOI：
10.1111/apa.15870
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发表时间：
2021-04-18
期刊：
影响因子：
3.8
通讯作者：
Valentini, Piero
中科院分区：
文献类型：
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作者：
Buonsenso, Danilo;Munblit, Daniel;Valentini, Piero
2.方法这项横断面研究包括在A大学政策基金会（Fondazione Policlinico Universitario A）诊断为微生物确诊（鼻咽拭子PCR分析）COVID-19（2020年3月至2020年10月通过鼻咽拭子）的所有≤ 18岁儿童。Gemelli IRCCS（罗马，意大利）。只有在评估前30天诊断为SARS-CoV-2感染的儿童才被纳入。排除了> 18岁或患有严重神经认知障碍的患者，因为这将不允许对调查中包括的体征和症状进行适当评估。使用由Long COVID ISARIC研究小组开发的问卷（附录S1），4对照顾者进行了关于其孩子健康的访谈，以评估持续症状。参与者在2020年9月1日至2021年1月1日期间接受了两名儿科医生的电话或门诊采访。对于在门诊环境中评估的患者，使用相同的调查，收集报告的症状，即使在访视时不存在（例如心动过速）。此外，在评估时没有进行调查，以排除其他原因，尽管调查有一个部分询问在此期间是否检测到其他可能的原因。参与者根据急性期的症状状态（有症状/无症状）、住院需求和从COVID-19诊断到随访评估的时间（< 60、60-120、> 120天）进行分组。使用t检验或ANOVA比较数值变量，使用卡方检验或Fisher精确检验（如适用）比较分类变量。所有分析均使用R版本4.0进行。3（R基金会）。本研究由A大学政策基金会机构伦理委员会批准。Gemelli IRCCS-圣心卡托利卡大学（ID 3777），所有参与者均同意参与。研究纳入了129名在2020年3月至11月期间确诊为COVID-19的儿童（平均年龄为11± 4. 4岁，62名（48. 1%）女性）。6名患有严重神经认知障碍的儿童因无法报告调查中包括的体征/症状而被排除。109名儿童（84.5%）通过电话采访，其余在门诊评估。在急性COVID-19期间，33名儿童（25.6%）无症状，96名（74.4%）有症状。总体而言，6例（4.7%）儿童住院，3例（2.3%）需要儿科重症监护室入院。在初步诊断COVID-19后，3人发展为多系统炎症综合征（2.3%）和2人发展为心肌炎（1.6%）。患者在COVID-19微生物诊断后平均162.5±113.7天接受评估。41.8%完全恢复，35.7%有一个或两个症状，22.5%有三个或更多症状（表S1）。
2. METHODSThis cross‐sectional study included all children≤ 18 year old diagnosed with microbiologically confirmed (PCR analysis on nasopharyngeal swab) COVID‐19 (through a nasopharyngeal swab from March 2020 to October 2020) in Fondazione Policlinico Universitario A. Gemelli IRCCS (Rome, Italy). Only children with a SARS‐CoV‐2 infection diagnosed 30 days before the assessment were included. Patients> 18 years old or with severe neurocognitive disability were excluded, since this would have not allowed a proper assessment of signs and symptoms included in the survey. Caregivers were interviewed about their child's health using a questionnaire (Appendix S1) developed by the Long COVID ISARIC study group, 4 for evaluation of persisting symptoms. Participants were interviewed by two paediatricians, either by phone or in the outpatient department, from 1 September 2020 to 1 January 2021. For those assessed in the outpatient settings, the same survey was used and symptoms reported were collected even if not present at the moment of the visit (eg tachycardia). Also, investigations were not performed at the moment of the assessment, in order to rule‐out other causes, although the survey has a section to ask whether other possible causes have been detected in the meantime. Participants were categorised into groups according to symptoms status during the acute phase (symptomatic/asymptomatic), need for hospitalisation and time from COVID‐19 diagnosis to follow‐up evaluation (< 60, 60–120,> 120 days). Numerical variables were compared using t test or ANOVA and categorical variables with chi‐square or Fisher's exact test where appropriate. All analyses were performed using R version 4.0. 3 (R Foundation). This study was approved by the Institutional Ethic Committee of the Fondazione Policlinico Universitario A. Gemelli IRCCS—Università Cattolica del Sacro Cuore (ID 3777), and all participants consented to participate.3. RESULTSOne hundred and twenty‐nine children diagnosed with COVID‐19 between March and November 2020 were enrolled (mean age of 11±4.4 years, 62 (48.1%) female). Six children with severe neurocognitive impairment were excluded due to impossibility to report signs/symptoms included in the survey. Hundred and nine children (84.5%) were interviewed by phone call, and the remaining during outpatient assessment. During the acute COVID‐19, 33 children (25.6%) were asymptomatic, and 96 (74.4%) had symptoms. Overall, 6 (4.7%) children were hospitalised, and 3 (2.3%) needed paediatric intensive care unit admission. After the initial diagnosis of COVID‐19, three developed multisystem inflammatory syndrome (2.3%) and two myocarditis (1.6%). Patients were assessed on average 162.5±113.7 days after COVID‐19 microbiological diagnosis. 41.8% completely recovered, 35.7% had one or two symptoms and 22.5% had three or more (Table S1).