湖南省新型冠状病毒肺炎感染者流行病学特征分析  

Epidemiological characteristics of patients with coronavirus disease 2019 in Hunan province

作　　者：胡世雄[1] 徐巧华[1] 罗垲炜[1] 杨浩[1] 孙倩莱[1] 刘子言 赵善露 曾舸[1] 张恒娇[1] 戴志辉 肖洁华[1] 高立冬[1] HU Shi-xiong;XU Qiao-hua;LUO Kai-wei;YANG Hao;SUN Qian-lai;LIU Zi-yan;ZHAO Shan-lu;ZENG Ge;ZHANG Heng-jiao;DAI Zhi-hui;XIAO Jie-hua;GAO Li-dong(Hunan Provincial Center for Disease Control and Prevention,Changsha,Hunan 410005,China)

机构地区：[1]湖南省疾病预防控制中心,湖南长沙410005

出　　处：《实用预防医学》2020年第4期385-388,共4页Practical Preventive Medicine

基　　金：湖南省科技厅课题(2020SK3012,湖南省新型冠状病毒感染的肺炎疫情监测系统研究);湖南省自然科学基金(2019JJ80115);湖南省卫生健康委员会科研计划课题(B2019039);科技部十三五科技重大专项课题:病毒性传染病病原谱和病毒基因变异变迁规律研究(课题编号:2018ZX10713002)。

摘　　要：目的掌握湖南新型冠状病毒肺炎(新冠肺炎)疫情流行病学特征,为遏制疫情提供科学依据。方法采用描述性流行病学研究,回顾性分析2020年1月1日—2月8日全省新冠肺炎确诊病例及无症状感染者的流行病学特征。结果疫情覆盖全省76.9%的县市区,输入性病例为总体第一来源,占49.4%(χ^2=701.61,P<0.01),但2020年2月份以来疫情明显下降,聚集性病例成为第一来源(Z=-2.10,P=0.04)。感染者中位年龄为确诊病例44岁、无症状感染者35岁,后者相对多发3~18岁人群(χ^2=65.52,P<0.01)。发病至首次就诊平均间隔2.6 d,发病至诊断平均间隔为5.3 d,医院隔离至诊断平均间隔为2.1 d;随着时间后移,发病至首次就诊间隔、发病至诊断间隔明显缩短(前者Z=-5.74,P<0.01;后者Z=-7.72,P<0.01)。既往有疾病史的比例越高,病情越严重(Z=2.71,P<0.01)。结论湖南新冠肺炎疫情已由输入为主转变为以本地感染为主阶段,需坚持防止疫情蔓延、扩散和避免人群接触为主的防控策略,强化密切接触者的排查管理工作。Objective To identify the epidemiological features of coronavirus disease 2019(COVID-19)in Hunan province so as to provide a scientific basis for effectively containing the COVID-19 epidemic.Methods Descriptive epidemiological methods were used to retrospectively analyze the epidemiological characteristics regarding confirmed COVID-19 cases and patients with asymptomatic 2019-nCoV infection in Hunan province from January 1 and February 8 in 2020 in the province.Results The COVID-19 epidemic spread to 76.9%of counties/cities in Hunan province.On the whole,the imported cases were identified as the first source,accounting for 49.4%(χ^2=701.61,P<0.01).However,a significant decline was observed in the epidemic since February 2020,with the first source shifting to locally clustered cases(Z=-2.10,P=0.04).The median ages of the confirmed cases and the patients with asymptomatic 2019-nCoV infection were 44 and 35 years,respectively,and the proportion of asymptomatic infection was found to be relatively higher in the group aged 3-18 years(χ^2=65.52,P<0.01).The average interval from onset to first visiting-doctor behavior was 2.6 days,that from onset to diagnosis 5.3 days,and that from isolation to diagnosis 2.1 days.As time went on,the intervals from onset to first visiting-doctor behavior as well as from onset to diagnosis were significantly shortened(the former:Z=-5.74,P<0.01;the latter:Z=-7.72,P<0.01).The higher the proportion of a history of underlying diseases,the severer the COVID-19(Z=2.71,P<0.01).Conclusions The COVID-19 epidemic in Hunan has shifted from imported-centered infection to local-centered infection.A prevention and control strategy with focus on containing epidemic spreading and avoiding close contact among people is needed to remain;meanwhile,strengthening the screening and management of close contacts involved in the epidemic is also necessary.

关 键 词：新型冠状病毒 流行病学 确诊病例 无症状感染者 病例来源 

分 类 号：R563.1+4[医药卫生—呼吸系统]