儿童新冠病毒Omicron株感染的临床表现与生物学基础

doi:10.12372/jcp.2022.22e0783

摘要/Abstract

摘要：

严重急性呼吸系统综合征冠状病毒2（SARS-CoV-2）不断变异,新突变株奥密克戎(Omicron)成为当前主要流行株。与此同时,儿童感染者显著增加,儿童患者的临床表型也发生变化,如上呼吸道感染尤其急性喉炎比例增多、肺炎表现减少等。这些临床特点有其生物学基础,如病毒刺突蛋白高度变异、与宿主受体亲和力增加、入侵宿主细胞途径转变、合胞体形成能力减弱等,导致Omicron在传染性、传播特征、临床表型、致病性和免疫逃逸能力方面均发生显著变化,并由此带来了预防、治疗及预后的不同。文章就儿童Omicron感染的临床表现及相关生物学基础进行阐述。

关键词: 严重急性呼吸系统综合征冠状病毒2, 新型冠状病毒病, 奥密克戎株, 刺突蛋白, 突变, 儿童

Abstract:

With the continuous evolution of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), many variants have emerged. A new variant, Omicron, has become the dominant Covid strain globally. The emergence of Omicron not only led to a significant increase in the number of cases in children, but also brought some special symptoms to pediatric patients. For example, Omicron mainly affects the upper respiratory tract, with more acute laryngitis and less pneumonia. These clinical features have biological basis, such as high variation of viral spike protein, increased affinity with host receptors, transition of invasion pathway of host cells, and weakened syncytial formation ability, which lead to significant changes in infectivity, transmissibility, clinical phenotype, pathogenicity and immune evasion capabilities of Omicron. And this brings about the difference in prevention, treatment and prognosis. This article reviews the clinical manifestations and biological basis of Omicron infection in children.

Key words: severe acute respiratory syndrome coronavirus 2, corona virus disease 2019, Omicron, spike protein, variation, child

徐言文, 王群, 项琳娟, 黄丽素. 儿童新冠病毒Omicron株感染的临床表现与生物学基础[J]. 临床儿科杂志, 2022, 40(10): 795-800.

XU Yanwen, WANG Qun, XIANG Linjuan, HUANG Lisu. SARS-CoV-2 Omicron variant infection in children: clinical manifestations and biological basis[J]. Journal of Clinical Pediatrics, 2022, 40(10): 795-800.

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