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

新冠肺炎會對兒童造成嚴重的并發癥和死亡風險

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.

一項由羅格斯大學研究人員合作展開的研究表明，兒童、青少年和青年所面對的嚴重新冠肺炎并發癥的風險要比之前所設想的大，而有潛在健康問題的人群則面臨更大的風險。

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

該研究結果發表于《美國醫學研究小兒科》（JAMA Pediatrics）。該研究首次介紹了北美地區重癥新冠肺炎兒童患者的情況。

"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,羅格斯大學羅伯特伍德約翰遜醫學院人口健康質量和實施科學學院兒科系系主任兼學術開發教授和副局長表示：“有關新冠肺炎不會影響年輕人的想法完全是錯誤的。有慢性疾病，包括有肥胖者的兒童在感染新冠肺炎后出現重癥的可能性更大，但是值得注意的是，沒有慢性疾病的兒童也同樣面臨風險。父母仍然不能掉以輕心。”

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.

研究追蹤了48位兒童和青年，其中包括新生兒及21歲的青壯年。這些人群均在3月和4月在美國和加拿大被收入兒科重癥監護室。超過80%的人群有慢性疾病，比如免疫抑制、肥胖、糖尿病、癲癇或慢性肺病。在這些人群當中，40%人群由于發育遲緩或基因突變而依靠技術支持。

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.

超過20%的人群由于新冠肺炎出現了二個或更多的器官系統衰竭，接近40%的人群需要呼吸機。在跟蹤期結束時，接近33%的新冠肺炎兒童患者仍未出院，其中三人仍然需要呼吸機，而其中一人則需要生命支持系統。兩位入院兒童在為期三周的研究期內死亡。

"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，羅格斯大學羅伯特伍德約翰遜醫學院參與研究的兒科重癥監護醫師表示，“這項研究使我們對新冠肺炎兒童患者早期的疾病負荷有了一個初步的了解。研究結果證實，這一新出現的疾病已經在3月流行并且普遍在兒童中引起嚴重癥狀。”研究人員表示，針對所研究的兒童，他們非常謹慎地以醫院結果為參考，援引了兒科重癥患者死亡率為4.2的數據。與之相對照的是已經刊登的、高達62%的重癥成人患者死亡率以及更低的呼吸衰竭發生率。

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

Kleinman強調表示，紐約大都會圈的醫生發現兒童似乎出現了一些新的與新冠肺炎有關的癥狀。

"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.

“盡管我們有關此項研究的數據收集已結束，但是我們將繼續與當地以及全國的同仁合作并將努力探索這些更加嚴重的并發癥”，他表示，同時援引一些令人關切的癥狀，比如心臟衰竭以及類似于川崎病的癥狀-兒童多重系統炎癥綜合癥等。

文章來源：科學日報    編輯：質控部Susan