屋尘螨 COVID-19与儿童哮喘发作的关系
2024/04/24
摘要
背景与目的：呼吸道病毒感染会增加婴儿和儿童患哮喘的风险。感染严重急性呼吸综合征冠状病毒2 (SARS-CoV-2)病毒可导致严重的肺部炎症和长时间的呼吸道症状。我们试图确定SARS-CoV-2感染是否会改变小儿哮喘事件的风险。
方法：这项回顾性队列研究检查了费城儿童医院护理网络内1至16岁的儿童，他们在 2020 年 3 月 1 日至 2021 年 2 月 28 日期间接受了 SARS-CoV-2 聚合酶链反应 （PCR） 检测。多变量 Cox 回归模型评估了 18 个月观察窗口内 SARS-CoV-2 PCR 阳性组和 SARS-CoV-2 PCR 阴性组之间新诊断哮喘的风险比。根据人口统计学特征、社会经济变量和特异性合并症对模型进行了调整。
结果：该研究共纳入27423名受试者。在调整后的分析中，SARS-CoV-2 PCR阳性对新哮喘诊断的风险没有显著影响（风险比[HR]：0.96;P = 0.79）。黑人种族（HR：1.49;P =0 .004）、食物过敏（HR:1.26;P =0 .025）和过敏性鼻炎（HR：2.30;P < 0.001）显著增加了新哮喘诊断的风险。早产（HR：1.48;P = 0.005）和BMI（HR：1.13;P < .001） 显著增加了5岁以下儿童新哮喘诊断的风险。
结论：SARS-CoV-2 PCR阳性与观察期内儿童新的哮喘诊断无关，证实了儿童哮喘的已知危险因素。这项研究为有SARS-CoV-2感染史的儿童的预后和护理提供了信息。
COVID-19 and Asthma Onset in Children.
James P, Senter, Laura K, Aisenberg, Jesse W, Dudley,
Abstrast
Background and Objective: Respiratory viral infections increase risk of asthma in infants and children. Infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus can cause severe lung inflammation and prolonged respiratory symptoms. We sought to determine whether SARS-CoV-2 infection modified pediatric incident asthma risk.
Methods: This retrospective cohort study examined children ages 1 to 16 within the Children's Hospital of Philadelphia Care Network who received polymerase chain reaction (PCR) testing for SARS-CoV-2 between March 1, 2020 and February 28, 2021. Multivariable Cox regression models assessed the hazard ratio of new asthma diagnosis between SARS-CoV-2 PCR positive and SARS-CoV-2 PCR negative groups within an 18-month observation window. Models were adjusted for demographic characteristics, socioeconomic variables, and atopic comorbidities.
Results：There were 27 423 subjects included in the study. In adjusted analyses, SARS-CoV-2 PCR positivity had no significant effect on the hazard of new asthma diagnosis (hazard ratio [HR]: 0.96; P = .79). Black race (HR: 1.49; P = .004), food allergies (HR: 1.26; P = .025), and allergic rhinitis (HR: 2.30; P < .001) significantly increased the hazard of new asthma diagnosis. Preterm birth (HR: 1.48; P = .005) and BMI (HR: 1.13; P < .001) significantly increased the hazard of new asthma diagnosis for children <5 years old.
Conclusions: SARS-CoV-2 PCR positivity was not associated with new asthma diagnosis in children within the observation period, although known risk factors for pediatric asthma were confirmed. This study informs the prognosis and care of children with a history of SARS-CoV-2 infection.
背景与目的：呼吸道病毒感染会增加婴儿和儿童患哮喘的风险。感染严重急性呼吸综合征冠状病毒2 (SARS-CoV-2)病毒可导致严重的肺部炎症和长时间的呼吸道症状。我们试图确定SARS-CoV-2感染是否会改变小儿哮喘事件的风险。
方法：这项回顾性队列研究检查了费城儿童医院护理网络内1至16岁的儿童，他们在 2020 年 3 月 1 日至 2021 年 2 月 28 日期间接受了 SARS-CoV-2 聚合酶链反应 （PCR） 检测。多变量 Cox 回归模型评估了 18 个月观察窗口内 SARS-CoV-2 PCR 阳性组和 SARS-CoV-2 PCR 阴性组之间新诊断哮喘的风险比。根据人口统计学特征、社会经济变量和特异性合并症对模型进行了调整。
结果：该研究共纳入27423名受试者。在调整后的分析中，SARS-CoV-2 PCR阳性对新哮喘诊断的风险没有显著影响（风险比[HR]：0.96;P = 0.79）。黑人种族（HR：1.49;P =0 .004）、食物过敏（HR:1.26;P =0 .025）和过敏性鼻炎（HR：2.30;P < 0.001）显著增加了新哮喘诊断的风险。早产（HR：1.48;P = 0.005）和BMI（HR：1.13;P < .001） 显著增加了5岁以下儿童新哮喘诊断的风险。
结论：SARS-CoV-2 PCR阳性与观察期内儿童新的哮喘诊断无关，证实了儿童哮喘的已知危险因素。这项研究为有SARS-CoV-2感染史的儿童的预后和护理提供了信息。
(中日友好医院呼吸与危重症医学科 万静萱 摘译 林江涛 审校)
(Pediatrics 2024/04/12; doi: 10.1542/peds.2023-064615. IF：5.359)
(Pediatrics 2024/04/12; doi: 10.1542/peds.2023-064615. IF：5.359)
COVID-19 and Asthma Onset in Children.
James P, Senter, Laura K, Aisenberg, Jesse W, Dudley,
Abstrast
Background and Objective: Respiratory viral infections increase risk of asthma in infants and children. Infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus can cause severe lung inflammation and prolonged respiratory symptoms. We sought to determine whether SARS-CoV-2 infection modified pediatric incident asthma risk.
Methods: This retrospective cohort study examined children ages 1 to 16 within the Children's Hospital of Philadelphia Care Network who received polymerase chain reaction (PCR) testing for SARS-CoV-2 between March 1, 2020 and February 28, 2021. Multivariable Cox regression models assessed the hazard ratio of new asthma diagnosis between SARS-CoV-2 PCR positive and SARS-CoV-2 PCR negative groups within an 18-month observation window. Models were adjusted for demographic characteristics, socioeconomic variables, and atopic comorbidities.
Results：There were 27 423 subjects included in the study. In adjusted analyses, SARS-CoV-2 PCR positivity had no significant effect on the hazard of new asthma diagnosis (hazard ratio [HR]: 0.96; P = .79). Black race (HR: 1.49; P = .004), food allergies (HR: 1.26; P = .025), and allergic rhinitis (HR: 2.30; P < .001) significantly increased the hazard of new asthma diagnosis. Preterm birth (HR: 1.48; P = .005) and BMI (HR: 1.13; P < .001) significantly increased the hazard of new asthma diagnosis for children <5 years old.
Conclusions: SARS-CoV-2 PCR positivity was not associated with new asthma diagnosis in children within the observation period, although known risk factors for pediatric asthma were confirmed. This study informs the prognosis and care of children with a history of SARS-CoV-2 infection.
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