Children face risk for severe complications and death from COVID-19

新冠肺炎会对儿童造成严重的并发症和死亡风险

Children, teens and young adults are at greater risk for severe complications from COVID-19 than previously thought and those with underlying health conditions are at even greater risk, according to a study coauthored by a Rutgers researcher.

一项由罗格斯大学研究人员合作展开的研究表明，儿童、青少年和青年所面对的严重新冠肺炎并发症的风险要比之前所设想的大，而有潜在健康问题的人群则面临更大的风险。

The study, published in JAMA Pediatrics, is the first to describe the characteristics of seriously ill pediatric COVID-19 patients in North America.

该研究结果发表于《美国医学研究小儿科》（JAMA Pediatrics）。该研究首次介绍了北美地区重症新冠肺炎儿童患者的情况。

"The idea that COVID-19 is sparing of young people is just false," said study coauthor Lawrence C. Kleinman, professor and vice chair for academic development and chief of the Department of Pediatrics' Division of Population Health, Quality and Implementation Science at Rutgers Robert Wood Johnson Medical School. "While children are more likely to get very sick if they have other chronic conditions, including obesity, it is important to note that children without chronic illness are also at risk. Parents need to continue to take the virus seriously."

研究的共同作者Lawrence C. Kleinman,罗格斯大学罗伯特伍德约翰逊医学院人口健康质量和实施科学学院儿科系系主任兼学术开发教授和副局长表示：“有关新冠肺炎不会影响年轻人的想法完全是错误的。有慢性疾病，包括有肥胖者的儿童在感染新冠肺炎后出现重症的可能性更大，但是值得注意的是，没有慢性疾病的儿童也同样面临风险。父母仍然不能掉以轻心。”

The study followed 48 children and young adults -- from newborns to 21 years old -- who were admitted to pediatric intensive care units (PICUs) in the United States and Canada for COVID-19 in March and April. More than 80 percent had chronic underlying conditions, such as immune suppression, obesity, diabetes, seizures or chronic lung disease. Of those, 40 percent depended on technological support due to developmental delays or genetic anomalies.

研究追踪了48位儿童和青年，其中包括新生儿及21岁的青壮年。这些人群均在3月和4月在美国和加拿大被收入儿科重症监护室。超过80%的人群有慢性疾病，比如免疫抑制、肥胖、糖尿病、癫痫或慢性肺病。在这些人群当中，40%人群由于发育迟缓或基因突变而依靠技术支持。

More than 20 percent experienced failure of two or more organ systems due to COVID-19, and nearly 40 percent required a breathing tube and ventilator. At the end of the follow-up period, nearly 33 percent of the children were still hospitalized due to COVID-19, with three still requiring ventilator support and one on life support. Two of the children admitted during the three-week study period died.

超过20%的人群由于新冠肺炎出现了二个或更多的器官系统衰竭，接近40%的人群需要呼吸机。在跟踪期结束时，接近33%的新冠肺炎儿童患者仍未出院，其中三人仍然需要呼吸机，而其中一人则需要生命支持系统。两位入院儿童在为期三周的研究期内死亡。

"This study provides a baseline understanding of the early disease burden of COVID-19 in pediatric patients," said Hariprem Rajasekhar, a pediatric intensivist involved in conducting the study at Robert Wood Johnson Medical School's Department of Pediatrics. "The findings confirm that this emerging disease was already widespread in March and that it is not universally benign among children."

The researchers said they were "cautiously encouraged" by hospital outcomes for the children studied, citing the 4.2 percent mortality rate for PICU patients compared with published mortality rates of up to 62 percent among adults admitted to ICUs, as well as lower incidences of respiratory failure.

Harprem Rajasekhar，罗格斯大学罗伯特伍德约翰逊医学院参与研究的儿科重症监护医师表示，“这项研究使我们对新冠肺炎儿童患者早期的疾病负荷有了一个初步的了解。研究结果证实，这一新出现的疾病已经在3月流行并且普遍在儿童中引起严重症状。”研究人员表示，针对所研究的儿童，他们非常谨慎地以医院结果为参考，援引了儿科重症患者死亡率为4.2的数据。与之相对照的是已经刊登的、高达62%的重症成人患者死亡率以及更低的呼吸衰竭发生率。

Kleinman noted that doctors in the New York metropolitan area are seeing what appears to be a new COVID-related syndrome in children.

Kleinman强调表示，纽约大都会圈的医生发现儿童似乎出现了一些新的与新冠肺炎有关的症状。

"Although our data collection for this study has ended, we continue to develop collaborations with colleagues in our region and across the country to try to understand these more severe complications," he said, citing concerns such as heart failure and the Kawasaki disease-like condition termed pediatric multi-system inflammatory syndrome as examples.

“尽管我们有关此项研究的数据收集已结束，但是我们将继续与当地以及全国的同仁合作并将努力探索这些更加严重的并发症”，他表示，同时援引一些令人关切的症状，比如心脏衰竭以及类似于川崎病的症状-儿童多重系统炎症综合症等。

文章来源：科学日报    编辑：质控部Susan