【摘要】 目的 探究新型冠状病毒Omicron变异株感染新生儿的临床特征。方法 将2022年12月7日—2023年1月12日(新型冠状病毒Omicron变异株流行期间)深圳新生儿数据协作网27家医院542例确诊为新型冠状病毒感染的住院新生儿作为研究对象,采用横断面调查方法调查其临床特征。根据有无症状分为无症状感染组及有症状感染组,比较两组患儿的临床特征、实验室检查结果、胸部X线检查结果及转归。结果 542例患儿中,男285例,女257例;515例(95.0%)为足月儿,27例(5.0%)为早产儿。无症状感染组60例,有症状感染组482例。轻型336例(69.7%),中型125例(25.9%),重型15例(3.1%),危重型6例(1.2%)。发热是最常见的症状(434例,90.0%),其次为咳嗽和/或吐沫(183例,38.0%)、鼻塞和/或流涕(131例,27.2%)、气促(36例,7.5%)、喂养不耐受(30例,6.2%)等。325例行胸部X线检查,其中肺部斑片状阴影或实变阴影136例(41.8%),气胸2例(0.6%),肺透过度降低2例(0.6%),余185例(57.0%)未见异常。396例(73.1%)予治疗,其中对症治疗341例(86.1%),使用抗生素治疗137例(34.6%),免疫球蛋白治疗4例(1.0%),呼吸支持治疗23例(5.8%)。542例患儿临床症状缓解后出院,住院时间中位数为5 d。有症状感染组白细胞计数、中性粒细胞计数、血红蛋白浓度、降钙素原水平低于无症状感染组(P<0.05),而血小板计数和血糖水平高于无症状感染组(P<0.05)。有症状感染组中性粒细胞减少、血小板计数升高及血红蛋白浓度下降患儿比例均高于无症状感染组(P<0.05)。结论 新型冠状病毒Omicron变异株感染新生儿多为轻型,以发热为主要表现。有症状感染患儿多伴有血中性粒细胞计数减少、血小板计数升高及血红蛋白下降等表现。患儿以对症治疗为主,预后良好。[中国当代儿科杂志,2023,25 (7):678-684]更多还原

【Abstract】 Objective To investigate the clinical characteristics of neonates infected with the Omicron variant of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).Methods A cross-sectional survey was conducted on542 hospitalized neonates with confirmed coronavirus disease 2019(COVID-19) in 27 hospitals in Shenzhen from December 7,2022,to January 12,2023(during the Omicron variant epidemic period).The neonates were divided into two groups:asymptomatic infection and symptomatic infection.The clinical characteristics,results of laboratory examination,chest X-ray findings,and outcome were compared between the two groups.Results Among the 542neonates,there were 285 males and 257 females.Among them,515(95.0%) were full-term infants,and 27(5.0%) were preterm infants.The asymptomatic infection group had 60 cases,and the symptomatic infection group had 482 cases.Among them,336 cases(69.7%) were mild,125 cases(25.9%) were moderate,15 cases(3.1%) were severe,and 6 cases(1.2%) were critical.Fever was the most common symptom(434 cases,90.0%),followed by cough and/or spitting(183cases,38.0%),nasal congestion and/or runny nose(131 cases,27.2%),shortness of breath(36 cases,7.5%),and feeding intolerance(30 cases,6.2%).Among the 325 cases who underwent chest X-ray examination,136 cases(41.8%) had patchy or consolidative shadows in the lungs,2 cases(0.6%) had pneumothorax,2 cases(0.6%) had decreased lung transparency,and 185 cases(57.0%) showed no abnormality.Among the 396 cases(73.1%) who received treatment,341cases(86.1%) received symptomatic treatment,137 cases(34.6%) received antibiotic treatment,4 cases(1.0%) received immunoglobulin treatment,and 23 cases(5.8%) received respiratory support treatment.All 542 neonates were discharged from the hospital after their clinical symptoms were relieved,and the median hospital stay was 5 days.The white blood cell count,neutrophil count,hemoglobin,and procalcitonin were lower in the symptomatic infection group than those in the asymptomatic infection group(P<0.05),while the platelet count and blood glucose levels were higher in the symptomatic infection group than those in the asymptomatic infection group(P<0.05).The proportions of neonates with decreased neutrophil count,increased platelet count,and decreased hemoglobin concentration were higher in the symptomatic infection group than those in the asymptomatic group(P<0.05).Conclusions Most neonates with COVID-19 caused by the Omicron variant of SARS-CoV-2 are mild,with fever as the predominant symptom.Symptomatic neonates with COVID-19 are often accompanied by decreased neutrophil count,increased platelet count,and decreased hemoglobin level.Symptomatic treatment is the main treatment,and the prognosis is good.[Chinese Journal of Contemporary Pediatrics,2023,25(7):678-684]更多还原