新型冠状病毒肺炎患者恢复期核酸检测复阳的临床分析  

Clinical characteristics of discharged COVID-19 patients with reappeared positive nucleic acid test

作　　者：胡星星 倪岚[1] 陈毅斐[1] 张利平[2] 程真顺[1,3] HU Xingxing;NI Lan;CHEN Yifei;ZHANG Liping;CHENG Zhenshun(Dept.of Respiratory and Critical Care Medicine,Zhongnan Hospital of Wuhan University,Wuhan 430071,Hubei,China;Social Medical Development,Zhongnan Hospital of Wuhan University,Wuhan 430071,Hubei,China;Wuhan Infectious Diseases and Cancer Research Center,Chinese Academy of Medical Sciences,Wuhan 430071,Hubei,China)

机构地区：[1]武汉大学中南医院呼吸与危重症医学科,湖北武汉430071 [2]武汉大学中南医院社会医疗发展部,湖北武汉430071 [3]中南医院中国医学科学院武汉感染性疾病及肿瘤研究中心,湖北武汉430071

出　　处：《武汉大学学报（医学版）》2021年第6期867-871,共5页Medical Journal of Wuhan University

基　　金：湖北省科技厅应急科技攻关项目(编号:2020FCA039);武汉市卫生计生委科研计划资助项目-武汉市新冠肺炎疫情防控应急科研专项项目(编号:EX20C07);武汉大学新型冠状病毒肺炎防治基金项目A类项目(编号:2042020kfxg21)。

摘　　要：目的:研究新型冠状病毒肺炎(COVID-19)患者达到出院标准后核酸检测复阳率,回顾性分析SARS-CoV-2病毒核酸检测复阳/未复阳患者的临床特征,为出院患者的隔离管理、健康监测及疫情防控提供决策依据。方法:将2020年2月—2020年3月期间武汉市3个新型冠状病毒肺炎患者出院后隔离观察点的188个病例分为核酸复阳组和未复阳组,比较分析两组的基本信息、症状表现、基础疾病、疾病严重程度、激素使用情况、住院时间、核酸转阴时间及复阳时间等临床特征。结果:在188例研究对象中,30例为核酸检测阳性,复阳率为15.96%,且复阳时间出现的范围为住院末次核酸阴性后第1~16天,中位天数为第5天。未复阳组中51例(32.28%)合并基础性疾病,而复阳组中18例(60.00%)合并基础性疾病,两组差异具有统计学意义(P<0.01);两组的性别、年龄、入院时症状、疾病严重程度、核酸转阴时间、是否使用激素等均无明显差异。结论:具有基础疾病的COVID-19患者复阳率较高,COVID-19患者按现有标准出院后仍需加强隔离防控,进一步健康监测,随诊复查。Objective:To investigate the incidence of reappearance of positive results of nucleic acid(NA)test in discharged COVID-19 patients,and retrospectively evaluate and compare the clinical characteristics between reappeared NA-positive group and NA-negative group,so as to provide the decision-making basis for the quarantine management,health monitoring,and epidemic prevention.Methods:A total of 188 cases of discharged COVID-19 patients from 3 quarantine observation sites in Wuhan from February to March 2020 were divided into reappeared NA-positive group and NA-negative group,based on the NA test.Clinical characteristics including general information,symptoms,underlying diseases,severity of disease,steroid administration,duration of hospitalization,duration from the beginning of positive to negative and time of onset of reappearance of positive for NA test,were compared between the two groups.Results:Of the 188 cases,30 cases(15.96%) reappeared positive for NA test,and onset of reappearance ranged from day 1 to day 16 since the last NA negative,with a median time of 5 days after onset.A total of 51 cases(32.28%) in NA-negative group had underlying diseases,while 18(60.0%) cases reappeared NA-positive had underlying diseases,and the rate of underlying diseases showed significant difference between the two groups(P<0.01).However,there were no statistical differences in gender,age,and symptoms on admission,severity of disease,steroid administration,duration from the beginning of positive to negative for NA test between the two groups.Conclusion:Since COVID-19 patients with underlying diseases showed higher incidence of reappearance of positive NA test,COVID-19 patients after discharge need to strengthen for quarantine control,further continuous health monitoring,and re-tests of SARS-CoV-2 nucleic acid.

关 键 词：新型冠状病毒 新型冠状病毒肺炎 核酸检测 核酸检测复阳 

分 类 号：R512.99[医药卫生—内科学]