英国牛津大学Ben Goldacre团队研究了和儿童一起生活与covid-19临床结局之间的相关性。2021年3月18日，该研究发表在《英国医学杂志》上。
为了调查在英国大流行的前两波疫情期间，有儿童和无儿童的成人感染SARS-CoV-2的风险和Covid-19的临床结局是否存在差异，研究组进行了一项基于人群的队列研究，使用在第1波（2020年2月1日至8月31日）和第2波（2020年9月1日至12月18日）疫情期间，来自英格兰的初级保健数据和匿名关联的医院和重症监护入院和死亡记录。
参与者为2020年2月1日和2020年9月1日在普通诊所登记的两组成人（18岁及以上）。主要观察指标为家庭中有儿童时SARS-CoV-2感染、与covid-19相关的入院或重症监护或因covid-19死亡的校正风险比。
在9334392名65岁及以下的成年人中，在第1波疫情期间，和儿童一起生活与记录在案的SARS-CoV-2感染、covid-19相关的住院或重症监护或covid-19死亡的风险显著增加无关。在第2波疫情中，在65岁及以下的成年人中，和任何年龄的儿童生活在一起均与记录的SARS-CoV-2感染风险增加相关，与0-11岁儿童生活在一起的SARS-CoV-2感染风险比为1.06，与12-18岁儿童生活在一起的风险比为1.22；与0-11岁儿童生活在一起covid-19相关住院的风险比为1.18，与12-18岁儿童生活在一起的风险比为1.26。
与年龄在0-11岁的儿童生活在一起，在两波疫情期间，covid-19和非covid-19原因导致的死亡风险都降低；而与任何年龄段的儿童生活在一起，均与非covid-19原因导致的死亡风险降低相关。在第2波疫情期间，65岁及以下的成年人，与0-11岁的儿童生活在一起会增加每1万人中感染SARS-CoV-2的绝对风险，从810人增加到850-870人，每1万人中住院人数增加1-5人，从160人增加到161-165人。与12-18岁儿童生活在一起，SARS-CoV-2感染人数每1万人中增加160-190人，住院人数每1万人中增加2-6人。
研究结果表明，与第1波疫情相比，在第2波疫情期间与儿童生活在一起的成人SARS-CoV-2感染和covid-19临床结局的风险增加。然而，这并没有转化为covid-19死亡率的实质性增加。
附：英文原文
Title: Association between living with children and outcomes from covid-19: OpenSAFELY cohort study of 12 million adults in England
Author: Harriet Forbes, Caroline E Morton, Seb Bacon, Helen I McDonald, Caroline Minassian, Jeremy P Brown, Christopher T Rentsch, Rohini Mathur, Anna Schultze, Nicholas J DeVito, Brian MacKenna, William J Hulme, Richard Croker, Alex J Walker, Elizabeth J Williamson, Chris Bates, Amir Mehrkar, Helen J Curtis, David Evans, Kevin Wing, Peter Inglesby, Henry Drysdale, Angel Y S Wong, Jonathan Cockburn, Robert McManus, John Parry, Frank Hester, Sam Harper, Ian J Douglas, Liam Smeeth, Stephen J W Evans, Krishnan Bhaskaran, Rosalind M Eggo, Ben Goldacre, Laurie A Tomlinson
Issue&Volume: 2021/03/18
Abstract:
Objective To investigate whether risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and outcomes of coronavirus disease 2019 (covid-19) differed between adults living with and without children during the first two waves of the UK pandemic.
Design Population based cohort study, on behalf of NHS England.
Setting Primary care data and pseudonymously linked hospital and intensive care admissions and death records from England, during wave 1 (1 February to 31 August 2020) and wave 2 (1 September to 18 December 2020).
Participants Two cohorts of adults (18 years and over) registered at a general practice on 1 February 2020 and 1 September 2020.
Main outcome measures Adjusted hazard ratios for SARS-CoV-2 infection, covid-19 related admission to hospital or intensive care, or death from covid-19, by presence of children in the household.
Results Among 9334392adults aged 65 years and under, during wave 1, living with children was not associated with materially increased risks of recorded SARS-CoV-2 infection, covid-19 related hospital or intensive care admission, or death from covid-19. In wave 2, among adults aged 65 years and under, living with children of any age was associated with an increased risk of recorded SARS-CoV-2 infection (hazard ratio 1.06 (95% confidence interval 1.05 to 1.08) for living with children aged 0-11 years; 1.22 (1.20 to 1.24) for living with children aged 12-18 years) and covid-19 related hospital admission (1.18 (1.06 to 1.31) for living with children aged 0-11; 1.26 (1.12 to 1.40) for living with children aged 12-18). Living with children aged 0-11 was associated with reduced risk of death from both covid-19 and non-covid-19 causes in both waves; living with children of any age was also associated with lower risk of dying from non-covid-19 causes. For adults 65 years and under during wave 2, living with children aged 0-11 years was associated with an increased absolute risk of having SARS-CoV-2 infection recorded of 40-60 per 10000 people, from 810 to between 850 and 870, and an increase in the number of hospital admissions of 1-5 per 10000 people, from 160 to between 161 and 165. Living with children aged 12-18 years was associated with an increase of 160-190 per 10000 in the number of SARS-CoV-2 infections and an increase of 2-6 per 10000 in the number of hospital admissions.
Conclusions In contrast to wave 1, evidence existed of increased risk of reported SARS-CoV-2 infection and covid-19 outcomes among adults living with children during wave 2. However, this did not translate into a materially increased risk of covid-19 mortality, and absolute increases in risk were small.
DOI: 10.1136/bmj.n628
Source: https://www.bmj.com/content/372/bmj.n628
BMJ-British Medical Journal:《英国医学杂志》，创刊于1840年。隶属于BMJ出版集团，最新IF：93.333
官方网址：http://www.bmj.com/
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本期文章：《英国医学杂志》：Online/在线发表
