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儿科固体器官移植受体中2019年严重的冠状病毒病:韩国的大数据融合研究 (K-COV-N队列)
Ji-Man Kang1, Minsun Kang2, Young-Eun Kim3
1Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, South Korea; Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, South Korea.
概括
经过固体器官移植 (SOT) 的儿童面临更高的严重COVID-19风险,包括需要呼吸支持或长时间住院治疗. 这些小儿SOT接受者需要定制的预防和管理策略.
科学领域:
- 儿科医学 儿科医学 儿科医学
- 传染病 传染病 传染病
- 移植医学 移植医学
背景情况:
- 儿科固体器官移植 (SOT) 接受者的严重COVID-19的风险尚未确定.
- 了解这种风险对于制定适合免疫功能低下儿童的护理策略至关重要.
研究的目的:
- 为了比较小儿SOT接受者和非SOT儿童之间严重的COVID-19感染的相对风险.
- 在这个脆弱人群中确定与严重的COVID-19相关的特定结果.
主要方法:
- 使用K-COV-N队列,包括从2008年1月到2022年1月的儿科COVID-19病例 (<18岁).
- 通过倾向性得分匹配,将206名儿科SOT接受者与803名非SOT儿童匹配.
- 根据呼吸系统支持需求定义的严重COVID-19:严重I (高流量鼻或长时间住院≥6天),严重II (任何氧气补充剂) 和严重III (任何氧气补充剂或长时间住院≥6天).
主要成果:
- 与非SOT儿童相比,儿童SOT接受者患重症I型COVID-19的风险增加了3.6倍,患重症III型COVID-19的风险增加了4.9倍.
- 大多数感染 (96.6%) 发生在Omicron变种期间,没有报告死亡率.
- 在接种疫苗的SOT接收者中没有观察到严重的COVID-19病例,尽管这一发现在统计学上没有显著意义.
结论:
- 儿科SOT接受者面临严重COVID-19结局的风险显著增加.
- 研究结果强调,对于免疫功能低下的儿科移植患者,需要专门的预防和治疗策略.
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