所有年龄段的儿童都可能患上 2019 冠状病毒病（COVID-19）并出现并发症。
了解儿童可能出现的 COVID-19 症状，以及如何保护孩子。
儿童感染 2019 冠状病毒病 （COVID-19) 的可能性有多大？
自疫情开始以来，儿童病例在美国所有 COVID-19 病例中约占 18%。
虽然儿童与成人一样可能感染 COVID-19，但儿童患重症的可能性较小。多达 50% 的儿童和青少年可能感染 COVID-19 但没有任何症状。但是，也有部分 COVID-19 患儿需要住院、在重症监护室治疗或使用呼吸机辅助呼吸。
某些医疗状况可能增加儿童患 COVID-19 重症的风险，包括：
- 肥胖症
- 糖尿病
- 哮喘
- 先天性心脏病
- 遗传病
- 影响神经系统或新陈代谢的状况
研究还表明，西裔和非西裔黑人儿童患 COVID-19 的比例远高于非西裔白人儿童。
COVID-19 对婴儿有何影响？
一岁以下的婴儿可能比大一点的儿童更容易罹患重症 COVID-19。
新生儿在分娩过程中或产后接触患病的照护者可能会感染 COVID-19。如果您患有 COVID-19 或因产后住院期间出现症状而正在等待检测结果，请在照顾新生儿时戴上合适的口罩并保持双手清洁。住院期间，可以将新生儿的婴儿床放在您的病床边，但尽可能与宝宝保持合理的距离。采取这些措施后，新生儿感染 COVID-19 的风险会有所降低。但如果您罹患重症 COVID-19，则可能需要暂时与新生儿分开。
患上 COVID-19 但没有症状的婴儿可出院回家，具体根据情况而定。建议婴儿照护者戴上口罩并经常洗手，以避免被传染。婴儿的医疗护理专业人员需要经常通过电话、远程诊视或上门诊视进行随访，时间持续 14 天。COVID-19 检测呈阴性的婴儿可以出院回家。
儿童 COVID-19 的症状有哪些？
感染 COVID-19 的儿童可能出现多种症状、仅出现少数几种症状或无任何症状。儿童感染 COVID-19 最常见的症状是咳嗽和发热。可能出现的症状包括：
- 发热
- 痰咳
- 胸部疼痛
- 新发味觉或嗅觉丧失
- 皮肤发生变化，例如脚部和手部出现皮肤变色
- 咽喉疼痛
- 恶心、呕吐、腹痛或腹泻
- 寒战
- 肌肉酸痛和疼痛
- 极度疲劳
- 新发剧烈头痛
- 新发鼻塞
在接触 COVID-19 病毒后，平均约 6 天内会出现 COVID-19 症状。很难判断您的孩子是否患有 COVID-19 或其他具有类似症状的疾病，如流感或花粉症。
如果您认为孩子可能患有 COVID-19：
- 咨询孩子的医疗护理专业人员。
- 除了就医以外，让孩子待在家里，不要与他人接触。如条件允许，让孩子使用单独的卧室和浴室。
- 根据需要，遵循美国疾病控制与预防中心（CDC）及贵国政府有关检疫和隔离措施的建议。
- 侧重于缓解症状。可能包括休息、大量饮水和和服用止痛药。
- 如果孩子的病情不断加重，请致电医疗护理专业人员。急症警示体征包括呼吸困难、胸部出现持续性疼痛或压迫感、新发意识模糊、无法醒来或保持清醒，或者皮肤、嘴唇或甲床变白、变灰或变青；具体取决于孩子的肤色。
是否对孩子进行 COVID-19 检测的决定因素可能因您所在地区而异。在美国，医疗护理专业人员会根据孩子的症状以及是否与 COVID-19 确诊病例有过密切接触来决定是否进行 COVID-19 诊断性检测。如果您的孩子患重症的风险较高，医疗护理专业人员也可能考虑对其进行检测。
检测 COVID-19 时，医疗护理专业人员会使用长条拭子从鼻腔后部采集样本（鼻咽拭子）。样本会送至实验室进行检测。如果您咳嗽有痰（咳痰），痰液可能会被送去检测。
COVID-19 鼻拭子检查期间安抚您的孩子
本视频是为了帮儿童做好 COVID-19 鼻拭子检查准备，帮助他们缓解一些潜在恐惧和焦虑。儿童做好准备接受医学检验时，他们变得更配合、更顺从，这为他们创造了积极的应对体验。制作本视频供 4 岁及 4 岁以上儿童观看。
妙佑医疗国际的儿童生活项目负责人 Jennifer Rodemeyer： 你好，我是 Jennifer，妙佑医疗国际儿童生活专家。我的工作就是帮助你这样的小朋友们做好医学检验准备。
你们可能听说了，有一种可能让人生病的病毒正在肆虐。病毒是一种微生物，小到你甚至看不到它。
一些感染这种病毒的人会发热或咳嗽，可能感觉浑身疼痛、劳累，而有些人可能感染了这种病毒但完全不会生病。人们可能因接触某些东西感染这种病毒。这就是为何需要经常用肥皂和清水洗手的原因。这种病毒还会通过咳嗽或打喷嚏传播。因此，务必在咳嗽或打喷嚏时掩住口鼻。
今天，不管你有没有生病，我们都需要给你做个检查，以便知道我们如何能将对你的医疗护理做到最好。这项医学检验会告诉我们你是否感染病毒。
在你做检查时，医生会穿上专用防护服。他们穿上这种衣服是为了保证自己和你的安全，免于感染。他们会戴上口罩遮住口鼻，戴上透明塑料面罩保护眼睛。
检查期间你要做的最重要事情就是坐好不要动，像个雕像一样。为了辅助确保你不移动，你的家长或其他照料者会在检查期间协助你保持不动和安静。医护人员需要用一根细长棉签探入到鼻子后部。为此，你需要抬起下巴，然后医护人员会把一根棉签在你的鼻子里放一小会儿，采集样本。
在这期间，你可能想要推开棉签，但请尽可能地保持不动，这点真的很重要，这样医务人员才能完成检查。棉签会在数秒内进出你的鼻子。
一些小朋友告诉我，进行检查前数到 3 或深呼吸能使他们放松，还有些小朋友告诉我，他们喜欢抱着最喜欢的毛绒玩具或毛毯。或许你有自己的放松方式。
记住，检查期间最重要的就是保持身体完全不动。
看到穿着不同衣服的医护人员，你可能会想很多，但你要知道，这个人很有爱心，而且想要帮你。
感谢你协助我们完成检查，让我们知道如何继续把对你的医疗护理做到最好。
"什么是儿童多系统炎症综合征（MIS-C）？
儿童多系统炎症综合征（MIS-C）是一种严重医疗状况，患儿身体的某些部位（例如心脏、肺、血管、肾脏、消化系统、大脑、皮肤或眼睛）会出现重度炎症。有证据表明，许多患儿曾感染 COVID-19 病毒，因为其抗体检测结果呈阳性，这意味着 MIS-C 可能是由 COVID-19 相关的免疫应答过度引起。
MIS-C 的可能体征和症状包括：
- 发热持续 24 小时或更长时间
- 呕吐
- 腹泻
- 胃痛
- 皮疹
- 心跳过快
- 呼吸急促
- 红眼
- 嘴唇和舌头发红或肿胀
- 感觉异常疲劳
- 手或脚发红或肿胀
- 头痛、头晕或头晕眼花
- 淋巴结肿大
MIS-C 的紧急警示体征包括：
- 昏睡或难以保持清醒
- 呼吸困难
- 新发意识模糊
- 皮肤、嘴唇或甲床发白、发灰或发青（具体取决于肤色）。
- 重度胃疼
如果孩子出现任何紧急警示体征或出现其他严重疾病的体征和症状，请带孩子去最近的急诊科或拨打 911 或当地的紧急电话。如果孩子病情不严重，但仍出现其他 MIS-C 体征或症状，请立即联系孩子的医疗护理专业人员以寻求建议。
感染 COVID-19 是否会对儿童产生长期影响？
所有感染过 COVID-19 的人都可能出现 COVID-19 后病症。研究表明，COVID-19 轻症和重症儿童出现了长期症状。儿童中最常见的症状包括：
- 疲倦或疲劳
- 头痛
- 难以入睡
- 难以集中注意力
- 肌肉和关节疼痛
- 咳嗽
这些症状可能影响您孩子上学或完成日常活动的能力。如果您的孩子出现长期症状，请考虑向孩子的老师反映孩子的需求。
美国儿童可接种哪种 COVID-19 疫苗？
在美国境内可接种以下 COVID-19 疫苗：
- 2023-2024 年度辉瑞－生物科技 COVID-19 疫苗，可用于 6 月龄及以上人群。
- 2023-2024 年度莫德纳 COVID-19 疫苗，可用于 6 月龄及以上人群。
- 2023-2024 年度诺瓦瓦克斯 COVID-19 疫苗，可用于 12 岁及以上人群。
通常而言，具有典型免疫系统的 4 岁以上人群可以接种适用其年龄段的任何经批准或许可的疫苗，而且通常不需要每次都接种同一款疫苗。
有些人群则应该在所有疫苗剂次接种同一疫苗制造商生产的疫苗，包括：
- 6 月龄至 4 岁儿童。
- 免疫系统功能低下的 5 岁及以上人群。
- 已接种过一剂诺瓦瓦克斯疫苗的 12 岁及以上人群应在两剂次中接种第二剂诺瓦瓦克斯疫苗。
如果您对自己或孩子接种的疫苗有任何疑问，请咨询医疗护理专业人员。如果出现以下情况，医疗护理团队可以为您提供帮助：
- 您或您孩子之前接种的疫苗已断货。
- 您不知道自己或孩子接种了哪种疫苗。
- 您或您的孩子开始接种多剂次疫苗，但由于副作用而无法完成全程接种。
我怎么做才能防止孩子感染 COVID-19？
您可以采取许多措施防止孩子感染和传播 COVID-19 病毒。CDC 建议：
- 接种疫苗。COVID-19 疫苗可降低感染和传播 COVID-19 的风险。符合接种条件的儿童可在接种 COVID-19 疫苗当天接种其他疫苗。
- 佩戴口罩。如果您所在地区有大量 COVID-19 住院病例，CDC 建议在室内公共场所佩戴合适的口罩。请勿给 2 岁以下的儿童或无法安全佩戴口罩的失能儿童戴口罩。
- 保持双手清洁。建议经常用肥皂和水洗手至少 20 秒，或使用酒精含量至少 60% 的含酒精洗手液清洁双手。让孩子在咳嗽或打喷嚏时用手肘或纸巾遮住口鼻。提醒孩子不要触摸眼睛、鼻子和嘴巴。教孩子在唱两遍完整的“生日快乐”歌（大约 20 秒）期间把手洗干净。
- 清洁房屋并消毒。定期清洁经常接触的表面和物体；如果家有访客，客人走后也要进行清洁。另外，定期清洁容易弄脏的区域，例如婴儿的尿布台，以及孩子经常触摸的表面和物品。
此外，坚持进行儿童健康体检，并让孩子及时接种其他疫苗，尤其是对于 2 岁以下的儿童而言。如果孩子要做检查但您担心孩子接触到 COVID-19 病毒，请向孩子的医生咨询正在采取的安全措施。不要因害怕感染 COVID-19 而不让孩子接种预防其他严重疾病的疫苗。
孩子可能很难遵循预防 COVID-19 病毒感染的指南。保持耐心。做个好榜样，您的孩子将更有可能效法您的行为。
What COVID-19 vaccines are available to kids in the U.S.?
The COVID-19 vaccines available in the United States are:
- 2023-2024 Pfizer-BioNTech COVID-19 vaccine, available for people age 6 months and older.
- 2023-2024 Moderna COVID-19 vaccine, available for people age 6 months and older.
- 2023-2024 Novavax COVID-19 vaccine, available for people age 12 years and older.
In general, people older than age 4 with typical immune systems can get any vaccine that is approved or authorized for their age. And people usually don't need to get vaccines from the same vaccine maker each time.
Some people should get all their vaccine doses from the same vaccine maker, including:
- Children age 6 months to 4 years.
- People age 5 years and older with weakened immune systems.
- People age 12 and older who have had one shot of the Novavax vaccine. They should get the second Novavax shot in the two-dose series.
Talk with your healthcare professional if you have any questions about the vaccines for you or your child. Your healthcare team can help you if:
- The vaccine you or your child got earlier isn't available.
- You don't know which vaccine you or your child received.
- You or your child started a vaccine series but couldn't finish it due to side effects.
What can I do to prevent my child from getting COVID-19?
There are many steps you can take to prevent your child from getting the COVID-19 virus and spreading it to others.
- Get vaccinated. If the timing works out, a COVID-19 vaccine can be given to eligible children on the same day as other vaccines.
- Keep hands clean. Encourage frequent hand-washing with soap and water for at least 20 seconds. Teach your kids to keep washing their hands until they have sung the entire "Happy Birthday" song twice, which takes about 20 seconds. Or use an alcohol-based hand sanitizer that contains at least 60% alcohol. Have your child cover the mouth and nose with an elbow or a tissue when coughing or sneezing. Remind your child to avoid touching the eyes, nose and mouth.
- Clean and disinfect your home. Clean high-touch surfaces and objects regularly and after you have visitors in your home. Also, regularly clean areas that easily get dirty, such as a baby's changing table, and surfaces and items that your child often touches.
- Get the air flowing. Use fans, open windows or doors, and use filters to keep air and germs moving out of your indoor space.
- Keep some distance. If possible, avoid close contact with anyone who is sick or has symptoms. Spread out in crowded indoor places, especially in places with poor airflow.
- Wear face masks. If you are in an area with a high number of people in the hospital with COVID-19, the CDC recommends wearing a well-fitted mask indoors in public. Don't place a face mask on a child younger than age 2 or a child with a disability who can't safely wear a mask.
Keep up with well-child visits and your child's other vaccines. COVID-19 is just one of many illnesses that can be prevented with vaccination. Vaccines for children are timed carefully. Vaccines are given when protection inherited from the mother fades and the child's immune system is ready, but before kids are likely to come in contact with the germs that cause real infections.
Following guidelines to protect against the COVID-19 virus can be difficult for kids. Stay patient. Be a good role model and your child will be more likely to follow your lead.
April 30, 2024
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