Clinical features of severe acute respiratory syndrome coronavirus 2 Omicron variant infection in children: an analysis of 201 cases / 中国当代儿科杂志

OBJECTIVES@#To study the clinical features of children with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant infection.@*METHODS@#A retrospective analysis was performed on the medical data of 201 children with coronavirus disease 2019 (COVID-19) who were hospitalized and diagnosed with SARS-CoV-2 Omicron variant infection in Quanzhou First Hospital from March 14 to April 7, 2022. Among the 201 children, there were 34 children with asymptomatic infection and 167 with symptomatic infection. The two groups were compared in terms of clinical features, results of experimental examinations, and outcome.@*RESULTS@#Of all the 201 children, 161 (80.1%) had a history of exposure to COVID-19 patients and 132 (65.7%) had a history of COVID-19 vaccination. Among the 167 children with symptomatic infections, 151 had mild COVID-19 and 16 had common COVID-19, with no severe infection or death. Among the 101 children who underwent chest CT examination, 16 had ground glass changes and 20 had nodular or linear opacities. The mean time to nucleic acid clearance was (14±4) days for the 201 children with Omicron variant infection, and the symptomatic infection group had a significantly longer time than the asymptomatic infection group [(15±4) days vs (11±4) days, P<0.05]. The group vaccinated with one or two doses of COVID-19 vaccine had a significantly higher positive rate of IgG than the group without vaccination (P<0.05). The proportions of children with increased blood lymphocyte count in the symptomatic infection group was significantly lower than that in the asymptomatic infection group (P<0.05). Compared with the asymptomatic infection group, the symptomatic infection group had significantly higher proportions of children with increased interleukin-6, increased fibrinogen, and increased D-dimer (P<0.05).@*CONCLUSIONS@#Most of the children with Omicron variant infection have clinical symptoms, which are generally mild. The children with symptomatic infection are often accompanied by decreased or normal blood lymphocyte count and increased levels of interleukin-6, fibrinogen, and D-dimer, with a relatively long time to nucleic acid clearance. Some of them had ground glass changes on chest CT.

Etiology of 142 cases of infant cholestasis and the evaluation of the common diagnostic methods / 中国实用儿科杂志

OBJECTIVE: To investigate the etiology of infant cholestasis,and to evaluate the commonly clinical diagnostic methods in diagnosing infant biliary atresia(BA). METHODS: A total of 142 hospitalized children with infant cholestasis in the pediatric ward of our hospital from January 1,2012 to November 30,2016 were included. RESULTS: Totally 99 cases(69.7%)were comfirmed,and the most common causes were BA,cytomegalovirus infection and citrin protein deficiency.Totally 37 cases(26.1%)were diagnosed as idiopathic infant hepatitis and 6 cases(4.2%)were undiagnosed. Compared with no-BA group,acholie stools predominated in BA group,and the serum γ-GT in BA were significantly higher. Abdominal ultrasonography showed that 81.2% were cholecyst undiscovered or small in size in BA. Hepatobiliary scintigraphy(HBS)showed that 95.0% had no image of gallbladder or radioactive concentration in bowel and 5.0% had delayed image or radioactive conceatration in BA. The difference between the two group;was statistical(P<0.01). The sensitivity,specificity,and accuracy of acholic stools to diagnose BAwere 91.3%,92.9%,and 92.2%,γ-GT≥300 U/Lwere 65.2%,91.8%,83.3%,abdominal ultrasonography were 68.8%,90.8%,84.9%,HBS were 95%,50%,68.0%,respectively. CONCLUSION: The common causes of infant cholestasis in BA,idiopathic hepatitis,cytomegalovirus infection,and Citrin protein deficiency. In the infant cholestasis with acholic stools,infracostal liver≥3 cm,serum γ-GT≥300 U/L,cholecyst undiscovered or small in size in abdominal ultrasonography,HBS undiscovered or delayed image of gallbladder or radioactive concentration in bowel,the BA should be suspected.

Study on the S region gene mutation of hepatitis B virus during prevention of HBV transmission in uterus with hepatitis B immunoglobulin / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the relationship between hepatitis B immunoglobulin (HBIG) injection before delivery and hepatitis B virus (HBV) S gene mutation.</p><p><b>METHODS</b>18 neonates infected with HBV in uterus and their mothers were divided to a) HBIG group (8) in which their mothers received HBIG injection before delivery and b) control group (10) in which their mothers never received any treatment HBV DNA fragments were amplified by nest-PCR from sera of these neonates and their mothers. S gene region of these HBV DNA fragments were directly sequenced and data on mutations was analyzed.</p><p><b>RESULTS</b>There was no significant difference on nucleotide and amino acid changes in the S gene between the HBIG group and the control group. The majority HBV strains of newborn (17/18) were identical to their mother's dominant strains before delivery, including four mutation HBV strains. Among 18 newborns with HBV intrauterine infection, 12 were infected by B type (adw2), and 6 by C type (adrq+).</p><p><b>CONCLUSION</b>Mothers who were asymptomatic HBsAg carrier and received injections ofHBIG before delivery would not be influenced by HBV S gene mutation. HBV intrauterine transmission with or without gene mutation might occur in the third-trimester of pregnancy. Gene mutation of HBV was not the main factor in intrauterine transmission of HBV.</p>

Study on a antepartum immunoprophylaxis to interrupt the transmission of hepatitis B virus from mother to infant / 中华传染病杂志

Objective To investigate the efficacy and the mechanism of different dose hepatitis B immunoglohulin(HBIG)on prevention of HBV intrauterine infection and HBV S gene mutation. Methods HBV carrier mothers were randomly divided into three groups.Eighty-one HBsAg carrier pregnant women were divided into HBIG A group.HBIG B group and control group.Each subject in the HBIG A group received 200 U or 400 U(for HBsAg and HBeAg double positive carrier)intra muscularly at 3,2,1 month before delivery.Each subject in the HBIG B group received 200 U intra muscularly at 3,2,1 month before delivery.The subjects in the control group did not receive any treatment.Maternal blood samples were taken before HBIG injection and at delivery.Neonatal blood samples of all newborn infants after birth were taken before immunopropbylaxis.Their sera were ob tained to test HBV markers by enzyme immunoassay(EIA)and HBV DNA by fluorescence quantita- tive polymerase chain reaction(FQ-PCR),then to amplify and sequence HBV S gene region.Results The rate of HBV intrauterine infection in the HBIG group(14.5%)was lower than that in the control group(35.7%)(X~2=4.896,P=0.027).The rate of HBV intrauterine infection of newborns from HBsAg and HBeAg double positive carrier mother in the HBIG A group(37.5%)were lower than control group(100.0%)(X~2=7.273,P=0.007),while the rate was no different in the HBIG B group(71.5%)and the control group(X~2=2.637,P=0.104).Maternal HBsAg titer and HBV DNA level were of no difference among three groups before HBIG injection.Maternal HBsAg titers and HBV DNA levels of the HBIG A group were lower than those of the HBIG B group and the con- trol group at delivery.Among the 26 neonatal serum samples in the HBIG A group,10(38.5%)were positive for anti-HBs,while in the HBIG B group and in the control group,no neonatal serum sam- ples was positive.There was no significant difference of nucleotide and amino acid changes in the S gene between the HBIG group and the control group.Conclusions HBV infection in the uterus may be interrupted by injection HBIG intramuscularly before delivery.More efficacy would be found using variable HBIG dose according to different HBV virema and must be once more again injected just he- fore one week of delivery;anti-HBs transported to the fetus via the placenta and it's may be the im- portant mechanism of HBIG prevention.Asymptomatic HBsAg carrier mother received injections of HBIG before delivery should not influence HBV S gene mutation.Gene mutation of HBV is not the main factor in intrauterine transmission of HBV.