{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T20:10:10Z","timestamp":1760818210157,"version":"build-2065373602"},"reference-count":26,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2025,3,3]],"date-time":"2025-03-03T00:00:00Z","timestamp":1740960000000},"content-version":"unspecified","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,12,19]]},"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To investigate the prevalence and factors of COVID-19 infection in children aged 0\u20136 years within Hunan Province following the deregulation of epidemic control.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>This is an observational study in epidemiology, using an on-site questionnaire survey to investigate the current status of COVID-19 infection and its influencing factors in children aged 0\u20136 years in Hunan Province from 16 February to 24 March 2023.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Multi-stage stratified sampling method was applied in this study. The regions were categorised as developed, medium and underdeveloped. One municipality was selected from each category. In each municipality, one district and one county were chosen for cluster sampling.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>Children aged 0\u20136 years in Hunan Province.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 78\u2009115 children aged 0\u20136 years were enrolled in this study, of 30\u2009659 (39.2%) had a confirmed positive SARS-CoV-2 test result or related clinical symptoms. The majority of COVID-19 infections in children were of mild type (92.0%), and very few were severe and critical (0.4% and 0.1%). The majority (74.6%\u201388.7%) of children had minimal lifestyle behavioural changes after infected with COVID-19. Parents of the child working as a staff member (OR=0.654, 95%\u2009CI: 0.603, 0.709) and civil servant (OR=0.865, 95%\u2009CI: 0.794, 0.941), living in a rural area (OR=0.384, 95%\u2009CI: 0.369, 0.400) and no COVID-19 exposure (OR=0.108, 95%\u2009CI: 0.104, 0.113) were protective factors for COVID-19 infection in children.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Children experienced a large number of COVID-19 infections following the deregulation, fewer severe cases and fewer changes in lifestyle. Easing epidemic control measures in the later stage of the pandemic did not aggravate the consequences of the epidemic.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-089651","type":"journal-article","created":{"date-parts":[[2025,3,3]],"date-time":"2025-03-03T16:56:32Z","timestamp":1741020992000},"page":"e089651","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Prevalence and factors of COVID-19 among children in Hunan, China, following the deregulation of epidemic control: an observational study in epidemiology"],"prefix":"10.1136","volume":"15","author":[{"given":"Lijia","family":"Wan","sequence":"first","affiliation":[{"name":"Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yixu","family":"Liu","sequence":"additional","affiliation":[{"name":"Central South University Xiangya School of Public Health, Changsha, Hunan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanfeng","family":"Tan","sequence":"additional","affiliation":[{"name":"Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan","family":"Xiao","sequence":"additional","affiliation":[{"name":"Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Binbin","family":"Feng","sequence":"additional","affiliation":[{"name":"Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junqun","family":"Fang","sequence":"additional","affiliation":[{"name":"Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6076-0337","authenticated-orcid":false,"given":"Donghua","family":"Xie","sequence":"additional","affiliation":[{"name":"Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,3,3]]},"reference":[{"key":"2025101812323334000_15.3.e089651.1","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1017\/ice.2020.162","article-title":"Borderless collaboration is needed for COVID-19-A disease that knows no borders","volume":"41","author":"Mohamed","year":"2020","journal-title":"Infect Control Hosp Epidemiol"},{"key":"2025101812323334000_15.3.e089651.2","unstructured":"Our World in Data, Available: https:\/\/ourworldindata.org"},{"key":"2025101812323334000_15.3.e089651.3","doi-asserted-by":"crossref","first-page":"1342","DOI":"10.1002\/ppul.25344","article-title":"COVID-19 in childhood: Transmission, clinical presentation, complications and risk factors","volume":"56","author":"Siebach","year":"2021","journal-title":"Pediatr Pulmonol"},{"key":"2025101812323334000_15.3.e089651.4","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2020-0702","article-title":"Epidemiology of COVID-19 Among Children in China","volume":"145","author":"Dong","year":"2020","journal-title":"Pediatrics"},{"key":"2025101812323334000_15.3.e089651.5","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.carrev.2021.04.007","article-title":"Systemic Inflammation May Induce Cardiac Injury in COVID-19 Patients Including Children and Adolescents Without Underlying Cardiovascular Diseases: A Systematic Review","volume":"35","author":"Saed Aldien","year":"2022","journal-title":"Cardiovasc Revasc Med"},{"key":"2025101812323334000_15.3.e089651.6","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.pediatrneurol.2020.10.005","article-title":"Fatal Cerebral Edema in a Child With COVID-19","volume":"114","author":"Kim","year":"2021","journal-title":"Pediatr Neurol"},{"key":"2025101812323334000_15.3.e089651.7","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2022.23253","article-title":"Post-COVID-19 Conditions Among Children 90 Days After SARS-CoV-2 Infection","volume":"5","author":"Funk","year":"2022","journal-title":"JAMA Netw Open"},{"key":"2025101812323334000_15.3.e089651.8","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6914e4"},{"key":"2025101812323334000_15.3.e089651.9","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-020-0962-9"},{"key":"2025101812323334000_15.3.e089651.10","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1111\/jpc.15811","article-title":"COVID-19 in children. 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