新生儿中冠状病毒感染的特点与防治
Characteristics and Prevention of Coronavirus Infection in Neonates

目的：研究分析新生儿冠状病毒感染的临床特征。方法：选取2022年10月~2023年10月浙江大学医学院附属儿童医院新生儿科收治的冠状病毒感染新生儿，收集患儿的一般情况、临床特征等，回顾性分析152例冠状病毒感染新生儿的临床特点，探讨重症新生儿冠状病毒感染危险因素。结果：共纳入152例冠状病毒感染新生儿，男性患儿85例(55.9%)，女性患儿67例(44.1%)，早产儿7例(4.6%)，足月儿145例(95.4%)，131例(86.2%)患儿出现发热，138例(90.8%)患儿行胸部X线检查，67例无异常，无一例患儿采用抗病毒治疗，绝大部分患儿予以对症治疗好转，所有患儿均好转出院，重症组患儿16例，轻症组患儿136例，与轻症组相比，重症组患儿更常出现胃纳下降(P < 0.001)，重症组氨基末端脑利钠肽前体和IL2均显著更高(P < 0.05)，重症组与轻症组患儿在性别、是否早产、发病年龄、发病季节方面差异无统计学意义，而胎盘异常及合并呼吸道合胞病毒感染在两组之间差异有统计学意义(P < 0.05)。结论：新生儿冠状病毒感染多为轻症感染，以发热和咳嗽、鼻塞流涕等呼吸道症状为主，即使重症患儿，近期预后良好，重症患儿更易出现胃纳下降，合并胎盘异常及呼吸道合胞病毒感染患儿更易发生重症感染。
Objective: To study and analyze the clinical features of neonatal coronavirus infection. Methods: The clinical features of 152 neonates with coronavirus infection admitted to the Neonatal Department of Zhejiang University School of Medicine from October 2022 to October 2023 were retrospectively analyzed. The risk factors for severe neonatal coronavirus infection were explored. Results: A total of 152 neonates with coronavirus infection were included in the study. Among them, 85 (55.9%) were male and 67 (44.1%) were female. There were 7 premature infants (4.6%) and 145 term infants (95.4%). 131 (86.2%) of the infants had fever, and 138 (90.8%) underwent chest X-ray examination. 67 infants had no abnormalities. No infant received antiviral treatment, and most of them were treated symptomatically and improved. All infants improved and were discharged. There were 16 severe cases and 136 mild cases. Compared with the mild group, the severe group had more frequent decreased appetite (P < 0.001). The levels of amino-terminal pro-brain natriuretic peptide (NT-proBNP) and IL-2 were significantly higher in the severe group (P < 0.05). There was no significant difference in gender, whether premature or not, age of onset, or season of onset between the severe and mild groups. However, there was a statistically significant difference between the two groups in placental abnormalities and co-infection with respiratory syncytial virus (RSV) (P < 0.05). Conclusion: Newborn coronavirus infections are mostly mild, with fever, cough, and nasal congestion and runny nose as the main respiratory symptoms. Even in severe cases, the prognosis is good in the short term. Children with severe infections are more likely to have decreased appetite, and those with placental abnormalities or respiratory syncytial virus