Az alapellátásban kezelt COVID-19-fertőzött gyermekek tünettani és epidemiológiai jellemzői

Osszefoglalo. Bevezetes: A COVID-19-pandemia kapcsan szamos tanulmany vizsgalta a tunetek gyakorisagat es a jarvanyterjedes jellemzőit gyermekkorban, keves azonban az alapellatas adatait osszefoglalo publikacio. Kozlemenyunkben 12 hazi gyermekorvosi praxis 545 SARS-CoV-2-fertőzott betegenek adatait elemeztuk a 2. (n = 293) es a 3. (n = 252) jarvanyhullamban. Celkitűzes: A gyermekkori fertőzesek tunettananak es epidemiologiai jellemzőinek osszehasonlitasa korcsoportok es jarvanyhullamok kozott. Modszer: Valamennyi alapellato praxis egyseges retrospektiv adatgyűjtest vegzett ugyanazon parameterek regisztralasaval. Eredmenyek: A 10 ev alatti betegekben a laz, a natha es a kohoges dominalt (30-50%), mig a 10 ev felettiekben magas aranyban regisztraltunk altalanos tuneteket is (30-40% fejfajas, gyengeseg, szaglaszavar). A 2. hullamban a 11-18 evesek (68%), a 3. hullamban a 0-10 evesek (53%) voltak tobbsegben. A 3. hullamban szignifikansan emelkedett a leguti tunetek előfordulasa, az altalanos tunetek gyakorisaga jelentősen csokkent, es szignifikansan nőtt a csaladon beluli expozicio aranya (36% vs. 58%) a 2. hullammal osszehasonlitva. A gyermekről csaladtagra tortenő tovabbterjedes 24% es 16% volt a ket jarvanyhullamban, es merteket az eletkor befolyasolta. Megbeszeles: A klinikai kep az eletkorral es a feltetelezett virusvarianssal mutatott osszefuggest: 10 ev alatt a leguti tunetek dominaltak, 10 ev felett szignifikansan tobb altalanos tunetet regisztraltunk a 0-10 evesekhez kepest. A 3. jarvanyhullamban az alfa-varians terjedesevel gyakoribba valtak a leguti tunetek, az iskolabezarasok kovetkezteben megvaltozott az eletkori megoszlas, es megemelkedett a csaladi expozicio okozta fertőzesek aranya. A fertőzes tovabbadasa haztartason belul mindket hullamban alacsony maradt. Kovetkeztetes: A COVID-19 klinikai megjeleneset es terjedesi jellemzőit jelentősen befolyasolta az erintett gyermekpopulacio eletkori osszetetele, a cirkulalo virusvarians es az aktualis korlatozo intezkedesek. Orv Hetil. 2021; 162(44): 1751-1760. Introduction During the COVID-19 pandemic, a large number of publications examined the frequency of symptoms and the mode of transmission in childhood but only a few community-based studies have been published. In our paper, 545 pediatric COVID-19 patients' data were collected by 12 primary care pediatricians in the second (n = 293) and third (n = 252) waves of the pandemic. Objective To compare the frequency of symptoms and household transmission in different age groups and between the two waves. Method Patients' data and disease characteristics were recorded retrospectively in the same manner by all participating pediatricians. Results In patients of 10 years, where high frequency of general symptoms was found (30-40% headache, weakness, anosmia). In the third wave, the ratio of the age group 11-18 years declined from 68% to 47%, the frequency of respiratory symptoms increased significantly, while the ratio of general symptoms decreased. Household exposition was more frequent in the third wave (36% vs. 58%), while the transmission rate from children to family members was 24% and 16%, respectively, and it varied with age. Discussion Clinical manifestation showed relation to age and virus variant: the older age associated with higher frequency of general symptoms and the spread of the alpha variant led to the predominance of respiratory symptoms over general complaints. Prolonged school closures affected the age distribution and increased the frequency of household exposition. Secondary household transmission remained low. Conclusion Clinical and epidemiological characteristics of pediatric COVID-19 disease were highly influenced by age, dominant virus variant and mitigation measures. Orv Hetil. 2021; 162(44): 1751-1760.