甘肃省SARS-CoV-2 Delta变异株感染的COVID-19流行病学和临床特征分析  

Epidemiological and clinical features of COVID-19 infected with SARS-CoV-2 Delta variant in Gansu Province

作　　者：周心怡[1] 王虹[1] 黄晖蓉[1] 张天明 万毅新[1] Zhou Xin-Yi;Wang Hong;Huang Hui-Rong;Zhang Tian-Ming;Wan Yi-Xin(Department of Respiratory,Second Hospital of Lanzhou University,Lanzhou 730030,China)

机构地区：[1]兰州大学第二医院呼吸内科,兰州730030

出　　处：《解放军医学杂志》2022年第4期359-366,共8页Medical Journal of Chinese People's Liberation Army

基　　金：甘肃省科技计划项目(20YF2FA025)。

摘　　要：目的分析新型冠状病毒(SARS-CoV-2)Delta变异株感染的新型冠状病毒肺炎(COVID-19)的流行病学及临床特征。方法回顾性分析2021年10月25日-11月19日兰州市第二人民医院雁滩分院收治的SARS-CoV-2 Delta变异株感染的本土138例COVID-19确诊患者的流行病学和临床特征,采集流行病学及人口学信息、临床症状、实验室检查、胸部CT、治疗和预后数据,最终随访日期为2021年11月27日。结果截至2021年11月19日,甘肃省此次疫情累计报告COVID-19确诊病例144例,其中兰州市第二人民医院雁滩分院集中收治138例,男65例(47.1%),女73例(52.9%),男女比例为1:1.12,年龄2~87(42.7±21.0)岁,临床分型以普通型(48.6%,67/138)为主。SARS-CoV-2 Delta变异株的传播方式以密闭空间为主,具有明显的旅行团聚集性和家庭聚集性;密切接触者筛查和社区排查是发现感染者的主要途径;86.2%(119/138)的确诊患者已接种国产COVID-19灭活疫苗;临床症状最常见的为咳嗽(57.2%,79/138),其次为咽痛(28.3%,39/138)、咽干(24.6%,34/138)、咳痰(21.0%,29/138)等,有发热症状的患者仅占20.3%(28/138),4例(2.9%)出现嗅觉、味觉减退或丧失。实验室检查血清淀粉样蛋白A和高密度脂蛋白胆固醇升高明显,SARS-CoV-2核酸检测ORF1ab基因Ct值为26.31±7.63,N基因为26.35±7.17;71.3%(72/101)的确诊患者胸部CT显示双侧肺叶受累,病灶位置以双肺下叶多见,病灶形态主要为片状、斑片状磨玻璃影。所有确诊患者均采用中西医结合治疗,以俯卧位通气和中医治疗为主,重症患者中医治疗率达100%,在呼吸支持、营养支持、抗凝的基础上配合中和抗体等免疫治疗。结论甘肃省SARS-CoV-2 Delta变异株感染的COVID-19确诊患者主要临床特征为发热比例低、病毒核酸转阴时间长、疫苗接种后重症风险低、治疗效果好,无插管,无体外膜肺氧合(ECMO),无死亡病例。“一人一方案”的中西医结合个性化治疗可有效控�Objective To analyze the epidemiological and clinical features of coronavirus disease 2019(COVID-19)infected with the Delta variant of SARS-CoV-2.Methods Retrospectively analyze the epidemiological and clinical features of 138 confirmed cases of COVID-19 infected with the Delta variant of SARS-CoV-2 from October 25,2021 to November 19,2021 in Yantan Branch of the Second People's Hospital of Lanzhou City.The epidemiological and demographic information,clinical symptoms,laboratory tests,chest CT,treatment and prognosis data were collected,with a final follow-up date of November 27,2021.Results As of November 19,2021,a total of 144 confirmed cases of COVID-19 were reported in Gansu Province,of which 138 cases[65 males(47.1%)and 73 females(52.9%),aged 2-87(42.7±21.0)years old,with the clinical classification of mainly common type(48.6%,67/138)]were concentrically treated in the Yantan Branch of the Second People's Hospital of Lanzhou City.The transmission mode of the Delta variant of SARS-CoV-2 is mainly in confined spaces,with obvious tour group and family aggregation;screening the close contacts and community investigation are the main approaches of finding the infected persons;86.2%(119/138)of confirmed patients have been vaccinated with the domestic inactivated COVID-19 vaccine.The most common clinical symptoms are cough(57.2%,79/138),followed by sore throat(28.3%,39/138),dry throat(24.6%,34/138),and expectoration(21.0%,29/138).Only 20.3%(28/138)of patients have fever,and 4 patients(2.9%)have decreased or lost sense of smell and taste.Laboratory tests showed that serum amyloid A and high-density lipoprotein cholesterol increased significantly.The Ct value of SARS-CoV-2 ORF1ab gene is 26.31±7.63,and N gene is 26.35±7.17.Chest CT fined that 71.3%(72/101)of confirmed patients showed bilateral lung lobes involvement,and the lesions are mostly located in the lower lobes of both lungs;the lesions are mainly flaky and patchy ground-glass opacities.All confirmed cases are treated with integrated traditional Chinese an

关 键 词：新型冠状病毒肺炎 新型冠状病毒Delta变异株 甘肃 临床特征 

分 类 号：R563[医药卫生—呼吸系统] R18[医药卫生—内科学]