儿科临界COVID-19的危险因素:系统审查和元分析
Camila Aparicio1, Zachary I Willis2, Mari M Nakamura3
1Department of Pediatrics, Yale University School of Medicine, New Haven, CT.
medRxiv : the preprint server for health sciences
|January 31, 2024
概括
在健康儿童中,临界COVID-19的绝对风险很低,但伴随性疾病显著增加了这种风险. 这凸显了儿童COVID-19管理中风险分层的必要性.
科学领域:
- 儿童传染病 儿童传染病
- 流行病学 流行病学
- 临界护理医学 临界护理医学
背景情况:
- 风险分层对于儿童的COVID-19管理至关重要.
- 本系统性审查和元分析定义了与儿童群体中关键COVID-19相关的临床特征和并发症.
研究的目的:
- 系统地审查和元分析与儿童和青少年关键COVID-19相关的临床特征和并发症.
- 为儿童COVID-19治疗的风险分层策略提供信息.
主要方法:
- 在Medline和EMBASE的系统文献搜索到2023年8月.
- 包括报告COVID-19患者年龄 ≤21岁结局数据的研究.
- 随机效应模型用于计算关键疾病的合并几率比率 (OR),定义为ICU入院,机械通风或死亡.
主要成果:
- 136项研究符合纳入标准;70项涉及172,165名参与者的研究被纳入了元分析.
- 在以前健康的儿童中,严重的COVID-19的绝对风险为4%.
- 伴随性疾病显著增加了COVID-19危急风险:OR为一个伴随性疾病的3.95,OR为≥2个伴随性疾病的9.51. 关键的危险因素包括心血管,神经,慢性肺病,糖尿病,肥胖和免疫性损害.
结论:
- 在没有潜在疾病的儿童中,严重的COVID-19的绝对风险很低.
- 一种或多种并发症显著提高了儿科患者患重症COVID-19的风险.
- 这些发现强调了风险分层对于量身定制的儿科COVID-19治疗的重要性.
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