一种bstract
当考虑没有先前免疫的个体时,成人的病例比例较少,而不是儿童对大多数传染病,但有很少的例外情况https://bit.ly/2Wsi6iJ
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Cristiani.等等。[1] have raised interesting questions in their editorial discussing the differences in coronavirus disease 2019 (COVID-19) morbidity and mortality between children and adults. The authors proposed a number of possible reasons to explain why children suffer less severe illness, including age-related variation in angiotensin-converting enzyme (ACE)2 receptor expression, trained immunity, and differences in lymphocyte and natural killer cell abundance. Whilst these hypotheses may be correct, we wish to challenge the notion that greater morbidity and mortality in adults is a remarkable feature of COVID-19. This is, in fact, the typical situation for most infections occurring in the absence of prior immunity.
新型Covid-19病毒在2019年底出现在以前未曝光和最完全易感的人口中,促进了世界各地的快速传播。自从良好的情况下,Covid-19的儿童患有比成年人更温和的疾病,整体临床结果更好。年龄特异性病例死亡率似乎在<10年龄≥80岁的成年人中的~13%~13%的儿童较近持续增加0%[2]。在全球范围内,儿童遭受最大传染病的最大负担,特别是呼吸道感染;因此,许多人都认为孩子们在儿童中的低负担被令人惊讶地看到。
However, for most common infectious diseases, the relationships between age and disease severity are influenced by acquisition of immunity, and because immunity is dependent on exposure it therefore increases with age. When only susceptible individuals are considered, age-specific mortality rates are typically higher in adults than in children for most infectious diseases. This was observed for measles in historical first-contact island epidemics [3.]最近,最近对新出现的传染病,包括严重急性呼吸综合征(SARS)[4.]西尼罗病毒感染[5.], and severe fever with thrombocytopenia syndrome (SFTS) [6.]。即使对于常见的感染而导致他们在儿童时期最大的负担,如原发性水痘感染的常见感染,类似的关系即使是常见的感染也很清楚7.] 和Plasmodium falciparum疟疾[8.],当考虑没有先前免疫的个体时。我们认为,在成年人中的Covid-19更大的负担主要反映了整个人口易感的事实,而不是严重程度和年龄之间的不寻常的关联。
Until we have better epidemiological data to be certain about denominators (numbers of infections in different age groups), it will be difficult to discern whether the relationship between age and case fatality ratio is monotonic or “J” shaped (with a higher case fatality ratio in the very youngest children compared with older children). However, comparisons between different age groups may tell us more about age-related host–pathogen interactions in general, than about the pathogenesis of COVID-19 specifically.
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Footnotes
利益冲突:S. EBMEIER无需披露。
Conflict of interest: A.J. Cunnington has nothing to disclose.
- R.eceived5月5日,2020年。
- 公认M.ay 8, 2020.
- 版权所有©ers 2020
此版本是根据Creative Commons归因非商业许可证4.0的条款分发。