Paediatric hospitalisations due to COVID-19 during the first SARS-CoV-2 omicron (B.1.1.529) variant wave in South Africa: a multicentre observational study.
Paediatric hospitalisations due to COVID-19 during the first SARS-CoV-2 omicron (B.1.1.529) variant wave in South Africa: a multicentre observational study.
复制标题
DOI：
10.1016/s2352-4642(22)00027-x
复制
发表时间：
2022-05
期刊：
影响因子：
--
通讯作者：
Feucht U
中科院分区：
文献类型：
--
作者：
Cloete J;Kruger A;Masha M;du Plessis NM;Mawela D;Tshukudu M;Manyane T;Komane L;Venter M;Jassat W;Goga A;Feucht U
自二零二一年十一月中旬起，南非报告COVID-19病例显著增加，始于Tshwane区，与SARS-CoV-2 omicron（B. 1. 1. 529）变种的快速社区传播相吻合。感染率的增加与儿科COVID-19相关住院（以下简称住院）的快速增加相吻合。Tshwane母婴COVID-19研究是一项多中心观察性研究，我们在该研究中调查了在南非COVID-19第四波疫情开始的6周期间，Tshwane地区SARS-CoV-2检测呈阳性并因任何原因入院的儿科患者（年龄≤19岁）的临床表现和结局。我们使用了五个数据源，分别是：（1）COVID-19行列表;（2）整理的SARS-CoV-2检测数据;（3）SARS-CoV-2基因组测序数据;（4）COVID-19住院监测;以及（5）13岁及以下儿童公共部门COVID-19相关住院的临床数据。2021年10月31日至12月11日期间，茨瓦内县有6287名儿童和青少年被记录为新冠肺炎患者。在此期间，2550名COVID-19患者住院治疗，其中462人（18%）年龄在19岁或以下。儿童病例的数量高于前三次SARS-CoV-2浪潮，在成人住院之前出现了反常的增加。对该地区成人和儿童的75份病毒样本进行了测序，其中74份（99%）为omicron变异体。在183名年龄≤13岁的COVID-19住院儿童中，有138名（75%）提供了详细的临床记录。138名儿童中有87名（63%）年龄为0-4岁。在138例病例中，61例（44%）的主要诊断为COVID-19，其中症状包括发热（61例中的37例[61%]）、咳嗽（35例[57%]）、呼吸急促（19例[31%]）、癫痫发作（19例[31%]）、呕吐（16例[26%]）和腹泻（15例[25%]）。中位住院时间为2天[IQR 1-3]）。138名有可用数据的儿童中有122名（88%）需要标准病房护理，27名（20%）需要氧疗。在研究期间，138名儿童中有7名（5%）接受了通气，4名（3%）死亡，均与复杂的基础共病有关。所有儿童和84名有数据的父母或监护人中的77名（92%）未接种COVID-19疫苗。儿童COVID-19病例和住院人数的迅速增加反映了南非Tshwane区SARS-CoV-2 omicron变异体的高社区传播。需要持续监测，以了解omicron变体对儿童和青少年的长期影响。南非医学研究理事会，南非科学与创新部，G7全球卫生基金。
South Africa reported a notable increase in COVID-19 cases from mid-November, 2021, onwards, starting in Tshwane District, which coincided with the rapid community spread of the SARS-CoV-2 omicron (B.1.1.529) variant. This increased infection rate coincided with a rapid increase in paediatric COVID-19-associated admissions to hospital (hereafter referred to as hospitalisations). The Tshwane Maternal-Child COVID-19 study is a multicentre observational study in which we investigated the clinical manifestations and outcomes of paediatric patients (aged ≤19 years) who had tested positive for SARS-CoV-2 and were admitted to hospital for any reason in Tshwane District during a 6-week period at the beginning of the fourth wave of the COVID-19 epidemic in South Africa. We used five data sources, which were: (1) COVID-19 line lists; (2) collated SARS-CoV-2 testing data; (3) SARS-CoV-2 genomic sequencing data; (4) COVID-19 hospitalisation surveillance; and (5) clinical data of public sector COVID-19-associated hospitalisations among children aged 13 years and younger. Between Oct 31 and Dec 11, 2021, 6287 children and adolescents in Tshwane District were recorded as having COVID-19. During this period, 2550 people with COVID-19 were hospitalised, of whom 462 (18%) were aged 19 years or younger. The number of paediatric cases was higher than in the three previous SARS-CoV-2 waves, uncharacteristically increasing ahead of adult hospitalisations. 75 viral samples from adults and children in the district were sequenced, of which 74 (99%) were of the omicron variant. Detailed clinical notes were available for 138 (75%) of 183 children aged ≤13 years with COVID-19 who were hospitalised. 87 (63%) of 138 children were aged 0–4 years. In 61 (44%) of 138 cases COVID-19 was the primary diagnosis, among whom symptoms included fever (37 [61%] of 61), cough (35 [57%]), shortness of breath (19 [31%]), seizures (19 [31%]), vomiting (16 [26%]), and diarrhoea (15 [25%]). Median length of hospital stay was 2 days [IQR 1–3]). 122 (88%) of 138 children with available data needed standard ward care and 27 (20%) needed oxygen therapy. Seven (5%) of 138 children were ventilated and four (3%) died during the study period, all related to complex underlying copathologies. All children and 77 (92%) of 84 parents or guardians with available data were unvaccinated to COVID-19. Rapid increases in paediatric COVID-19 cases and hospitalisations mirror high community transmission of the SARS-CoV-2 omicron variant in Tshwane District, South Africa. Continued monitoring is needed to understand the long-term effect of the omicron variant on children and adolescents. South African Medical Research Council, South African Department of Science & Innovation, G7 Global Health Fund.