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, Connecticut, USA.
Journal of the Pediatric Infectious Diseases Society
|May 23, 2024
概括
没有健康状况的儿童患重症COVID-19的风险很低. 然而,一种或多种并发症显著增加了这种风险,突出显示了儿童护理中需要仔细评估风险的必要性.
科学领域:
- 儿童传染病 儿童传染病
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 风险分层对于儿童的COVID-19管理至关重要.
- 了解儿科患者中关键COVID-19的临床特征和并发症至关重要.
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管理提供风险分层策略的信息.
主要方法:
- 在Medline和EMBASE的系统文献搜索到2023年8月31日.
- 包括报告COVID-19患者年龄 ≤21岁结局数据的研究.
- 随机效应模型用于估计危急疾病的合并几率比率,定义为机械通风,ICU入院或死亡.
主要成果:
- 136项研究符合纳入标准;70项研究 (172,165名患者) 纳入了分析.
- 在以前健康的儿童中,临界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:一个伴随性疾病的OR为3.95,≥2个伴随性疾病的OR为9.51. 关键的危险因素包括心血管,神经,慢性肺病 (不包括喘),糖尿病,肥胖和免疫性损害.
结论:
- 在健康的儿童和青少年中,严重的COVID-19的绝对风险很低.
- 一种或多种并发症的存在显著提高了严重的COVID-19的风险.
- 研究结果强调了风险分层对于量身定制儿科COVID-19治疗和管理的重要性.
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