广西144例家族聚集性新型冠状病毒奥密克戎变异株感染者的临床特征分析

Clinical characteristics of 2019-nCoV Omicron variant infection: A familial cluster of 144 cases in Guangxi Province

  • 摘要:
      背景  2022年2月中国广西发现了家族聚集性新型冠状病毒肺炎(COVID-19)奥密克戎感染病例,其临床特点尚不明确。
      目的  探讨广西本土聚集性新型冠状病毒奥密克戎病例的临床特征,为疫情防控提供依据。
      方法  收集广西2022年2月4日- 3月2日收治的本土奥密克戎感染聚集病例144例,对其血清学、生化学结果和疫苗接种、住院情况等信息进行统计分析,同时运用单因素和多因素logistic回归探讨这些临床特征与普通型新型冠状病毒肺炎的相关性。
      结果  144例患者中,男性80例,女性64例,平均年龄(34.55 ± 18.6)岁。新型冠状病毒肺炎分型:轻型56例(38.9%),普通型86例(59.7%),重型2例(1.4%),无危重型。普通型患者乳酸脱氢酶Md(IQR):185(165 ~ 219) U/L vs 172(152 ~ 207) U/L、谷丙转氨酶Md(IQR):20(15 ~ 31) U/L vs 16(11.8 ~ 21.2) U/L、谷草转氨酶Md(IQR):25(21 ~ 31) U/L vs 22(18 ~ 30) U/L水平明显高于轻型患者,且年龄明显大于轻型Md(IQR):35(21 ~ 47)岁 vs 29(18 ~ 37)岁,P均<0.05。接种3剂或2剂疫苗的患者平均住院时间明显短于接种1剂或未接种1剂的患者(21.48 ± 5.60) d和(22.22 ± 6.15) d vs (26.36 ± 5.07) d,P<0.05。随访1个月,6%(8/144)患者偶有轻度咳嗽,其他无不适。多因素logistic回归分析发现,年龄与普通型感染有关,中老年人发生普通型新型冠状病毒肺炎的风险是青少年的13.519倍(P<0.001)。
      结论  奥密克戎本土聚集感染病例,肺部感染(普通型)患者年龄较大,生化反应较轻型强。中老人发生发展为新型冠状病毒肺炎普通型的风险较青少年高,接种多剂疫苗仍是预防和控制疾病的重要手段。

     

    Abstract:
      Background  In February 2022, a familial cluster of 2019-nCoV Omicron variant infection occurred in Guangxi Province, China. The clinical characteristics of Omicron infection remain unclear.
      Objective   To investigate the clinical characteristics of local aggregative 2019-nCoV Omicron cases in Guangxi, and provide evidence for its prevention and control.
      Methods  A total of 144 Omicron family cluster infection cases admitted from February 4 to March 2, 2022 in Guangxi were collected. Their serological and biochemical results, vaccination and hospitalization status were statistically analyzed, and the correlation between these clinical features and COVID-19 moderate cases were analyzed by univariate and multivariate Logistic regression.
      Results  Among 144 patients, 80 were male and 64 were female, with an average age of (34.55 ± 18.6) years. Fifty-six cases (38.9%) were classified as mild COVID-19, 86 cases (59.7%) were moderate, and 2 cases (1.4%) were severe, without any critical cases. Moderate cases showed significantly higher lactic dehydrogenase (LDH), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) levels (MdIQR: 185165-219 U/L vs 172152-207 U/L, 2015-31 U/L vs 1611.8-21.2) U/L, 2521-31 U/L vs 2218-30 U/L, all P<0.05), and were older (35 21, 47 years vs 29 18, 37 years, P=0.001) than mild cases. The average length of hospital stay was significantly shorter for patients who had received 3 or 2 doses of vaccine than for those who had received 1 or no dose of vaccine (21.48 ± 5.60 d vs 26.36 ± 5.07 d, 22.22 ± 6.15 d vs 26.36 ± 5.07 d, P<0.05, respectively). During the 1-month follow-up, 6% (8/144) of the patients had occasional mild cough and no other discomfort. Univariate and multivariate Logistic regression analysis showed that age was associated with moderate cases. The risk of moderate cases was 13.519 times higher in older adults than in younger adults (P<0.001).
      Conclusion  In the Omicron family cluster of infections, patients with pulmonary infection (moderate cases) are found to be older and to have stronger biochemical reactions than those with mild cases. Older adults have a higher risk of developing moderate type of COVID-19 than younger adults. Receiving multiple vaccine doses is still an important means of disease prevention and control.

     

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