Abstract：
The Omicron variant BA.2 was the dominant variant in the COVID-19 outbreak in Shanghai since March 2022. We aim to investigate the characteristics of SARS-CoV-2 Omicron variant infection in pediatric liver-transplanted recipients.
We conducted a single-center, prospective, observational, single-arm study. We enrolled pediatric liver-transplanted patients infected with the Omicron variant BA.2 from March 19th to October 1st, 2022 and analyzed their demographic, clinical, laboratory, and outcome data. The management of COVID-19 was conducted according to the 9th trial edition of the Chinese guideline. The immunosuppressive therapy was tailored considering the patients\' infection developments and liver functions.
Five children were included. The primary diseases included Niemann-Pick disease, propionic acidemia, decompensated cirrhosis, biliary atresia, and Crigler-Najjar syndrome type I. All of the patients were onset with fever before or when getting RNA-positive results at the age of 3 (Range: 1-13) years. The infection duration was 29 (Range: 18-40) days. Three and two children were diagnosed with mild and moderate COVID-19 respectively. Two patients were tested RNA-positive within 14 days after having been tested negative. The immunosuppressants were paused or extenuated in four patients. Eight of all nine cohabitants were injected with at least two doses of inactivated SARS-CoV-2 vaccine. The disease courses were significantly longer than the patients (P < 0.05).
Post-transplant immunosuppression slows down the virus clearance and increases the risk of relapse but does not affect symptom duration or infection severity in pediatric patients. Patients can usually gain a favorable outcome and prognosis by extenuating immunosuppressants.
We conducted a single-center, prospective, observational, single-arm study. We enrolled pediatric liver-transplanted patients infected with the Omicron variant BA.2 from March 19th to October 1st, 2022 and analyzed their demographic, clinical, laboratory, and outcome data. The management of COVID-19 was conducted according to the 9th trial edition of the Chinese guideline. The immunosuppressive therapy was tailored considering the patients\' infection developments and liver functions.
Five children were included. The primary diseases included Niemann-Pick disease, propionic acidemia, decompensated cirrhosis, biliary atresia, and Crigler-Najjar syndrome type I. All of the patients were onset with fever before or when getting RNA-positive results at the age of 3 (Range: 1-13) years. The infection duration was 29 (Range: 18-40) days. Three and two children were diagnosed with mild and moderate COVID-19 respectively. Two patients were tested RNA-positive within 14 days after having been tested negative. The immunosuppressants were paused or extenuated in four patients. Eight of all nine cohabitants were injected with at least two doses of inactivated SARS-CoV-2 vaccine. The disease courses were significantly longer than the patients (P < 0.05).
Post-transplant immunosuppression slows down the virus clearance and increases the risk of relapse but does not affect symptom duration or infection severity in pediatric patients. Patients can usually gain a favorable outcome and prognosis by extenuating immunosuppressants.
摘要：
背景：Omicron变异体BA.2是2022年3月以来上海COVID-19爆发的主要变异体。我们旨在研究小儿肝移植受者中SARS-CoV-2Omicron变异体感染的特征。
方法：我们进行了单中心，prospective,观察,单臂研究。我们招募了3月19日至10月1日感染Omicron变异BA.2的儿童肝移植患者，2022年并分析了他们的人口统计，临床,实验室,和结果数据。COVID-19的管理按照中国指南第9版进行。免疫抑制治疗是根据患者的感染发展和肝功能量身定制的。
结果：纳入5名儿童。原发疾病包括尼曼-皮克病，丙酸血症,失代偿期肝硬化,胆道闭锁,和Crigler-Najjar综合征I型，所有患者在3岁（范围：1-13）岁时获得RNA阳性结果之前或之后均出现发烧。感染持续时间为29(范围:18-40)天。分别有3名和2名儿童被诊断为轻度和中度COVID-19。两名患者在测试阴性后14天内测试RNA阳性。在四名患者中暂停或扩大了免疫抑制剂。所有9名同居者中的8名注射了至少两剂灭活的SARS-CoV-2疫苗。病程明显长于患者(P<0.05)。
结论：移植后免疫抑制会减慢病毒清除速度，增加复发风险，但不会影响儿科患者的症状持续时间或感染严重程度。患者通常可以通过延长免疫抑制剂获得良好的预后和预后。
方法：我们进行了单中心，
结果：纳入5名儿童。
结论：移植后免疫抑制会减慢病毒清除速度，增加复发风险，但不会影响儿科患者的症状持续时间或感染严重程度。
