泉州市Omicron变异株BA.2感染普通型患者临床特征及影响核酸转阴时间的因素
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福建医科大学附属泉州第一医院重症医学科, 福建 泉州 362000

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林天来  E-mail: ltl688@163.com

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福建省自然科学基金卫生行业联合资金新上项目(2019J01597);泉州市医疗卫生领域指导性科技计划项目(2021N062S)


Clinical characteristics and factors affecting nucleic acid negative conversion time of moderate COVID-19 patients infected with Omicron variant BA.2 in Quanzhou City
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Department of Critical Care Medicine, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou 362000, China

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    摘要:

    目的 观察泉州市奥密克戎(Omicron)变异株BA.2感染普通型新型冠状病毒肺炎(COVID -19)患者的临床特征, 分析影响核酸转阴时间的因素。 方法 收集2022年3月13日—4月5日福建医科大学附属泉州第一医院收治的67例Omicron变异株BA.2感染普通型COVID -19患者的临床资料, 回顾性分析其临床特征及新型冠状病毒(SARS-CoV-2)核酸转阴时间的影响因素。 结果 入组患者男女比例为1∶1.03, 年龄为9~97(41.45±17.51)岁, 35.82%患有基础疾病, 83.58%接种了新冠疫苗。初诊时最常见临床症状为咳嗽(62.69%), 其次为发热(32.84%)。白细胞计数降低、中性粒细胞百分比升高和淋巴细胞计数降低的比率分别为11.94%、7.46%、29.85%, 天冬氨酸氨基转移酶、丙氨酸氨基转移酶、乳酸脱氢酶、肌酸激酶、肌酸激酶同工酶升高的比率分别为8.95%、10.45%、25.37%、14.93%、14.93%, C反应蛋白(CRP)、白细胞介素-6、血沉、降钙素原升高的比率分别为35.82%、71.64%、56.72%、4.48%, D -二聚体、肌酐、铁蛋白升高的比率分别为8.95%、28.36%、13.43%, 46.27%的患者IgG抗体阳性。肺部CT以双下肺外周多发、散在病灶为主, 斑片状高密度影及磨玻璃影多见, 1.49% 的患者出现少量双侧胸腔积液。10.45%的患者出现并发症, SARS-CoV-2核酸转阴时间平均(18.12±5.37)d, 住院时间平均(19.45±5.41)d, 所有患者均未进展为重型/危重型, 全部治愈出院。有呼吸系统疾病、CRP升高为SARS-CoV-2核酸转阴时间延长的独立危险因素(均P<0.05)。 结论 泉州市Omicron变异株BA.2感染普通型COVID -19患者初诊临床症状较轻, 咳嗽为最常见症状, 部分合并基础疾病, 绝大部分完成新冠疫苗接种, 经积极治疗后预后良好。SARS-CoV-2核酸转阴时间较长, 与呼吸系统疾病、CRP升高明显相关。

    Abstract:

    Objective To observe the clinical characteristics of moderate coronavirus disease 2019 (COVID -19) patients infected with Omicron variant BA.2 in Quanzhou City, and analyze risk factors for nucleic acid negative conversion time. Methods Clinical data of 67 moderate COVID -19 patients infected with Omicron variant BA.2 in Quanzhou First Hospital Affiliated to Fujian Medical University from March 13, 2022 to April 5, 2022 were collected, clinical characteristics and influencing factors for nucleic acid negative conversion time were retrospectively analyzed. Results The male to female ratio of the enrolled patients was 1 ∶1.03, the age ranged from 9 to 97 (41.45±17.51) years old, 35.82% of patients had underlying diseases, and 83.58% received COVID -19 vaccine. The most common clinical symptom at the initial diagnosis was cough (62.69%), followed by fever (32.84%). The proportions of decreased white blood cell (WBC) count, increased neutrophil percentage and decreased lymphocyte count were 11.94%, 7.46% and 29.85% respectively, the increased proportions of aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, creatine kinase and creatine kinase isoenzyme were 8.95%, 10.45%, 25.37%, 14.93% and 14.93% respectively, the increased proportions of C-reactive protein (CRP), interleukin-6, erythrocyte sedimentation rate and procalcitonin were 35.82%, 71.64%, 56.72% and 4.48%, respectively; the increased proportions of D-dimer, creatinine and ferritin were 8.95%, 28.36% and 13.43%, respectively, 46.27% of the patients were positive for IgG antibodies. Pulmonary CT mainly showed multiple and scattered lesions in the periphery of both lower lungs, patchy high-density shadow and ground glass shadow were more common, and 1.49% of patients had a small amount of bilateral pleural effusion. 10.45% of the patients had complications, the average time of nucleic acid negative conversion of SARS-CoV-2 was (18.12±5.37) days, the average time of hospitalization was (19.45±5.41) days. None of patients progressed to severe/critical disease, all were cured and discharged from hospital. Respiratory disease and elevated CRP were independent risk factors for prolonged SARS-CoV-2 nucleic acid negative conversion time(all P < 0.05). Conclusion Clinical symptoms of moderate COVID -19 patients infected with Omicron variant BA.2 in Quanzhou City were mild at the initial diagnosis, cough was the most common symptom, and some patients were complicated with underlying diseases, most of them completed COVID -19 vaccination, the prognosis was good after active treatment. SARS-CoV-2 nucleic acid negative conversion time is long, which is significantly related to respiratory diseases and elevated CRP.

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张洪玲,李才辉,魏思灿,等.泉州市Omicron变异株BA.2感染普通型患者临床特征及影响核酸转阴时间的因素[J]. 中国感染控制杂志,2022,(11):1096-1104. DOI:10.12138/j. issn.1671-9638.20223080.
Hong-ling ZHANG, Cai-hui LI, Si-can WEI, et al. Clinical characteristics and factors affecting nucleic acid negative conversion time of moderate COVID-19 patients infected with Omicron variant BA.2 in Quanzhou City[J]. Chin J Infect Control, 2022,(11):1096-1104. DOI:10.12138/j. issn.1671-9638.20223080.

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  • 收稿日期:2022-06-28
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  • 在线发布日期: 2024-04-28
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