362例是否接种新冠疫苗的奥密克戎变异株感染患者临床特征分析  

Analysis of clinical characteristics of 362 vaccinated or unvaccinated patients infected by novel coronavirus Omicron variant

作　　者：冯全胜[1] 王志勇[1] 于洪志 史丽霞 徐磊[1] Feng Quansheng;Wang Zhiyong;Yu Hongzhi;Shi Lixia;Xu Lei(Intensive Care Unit,the Third Central Hospital of Tianjin,Tianjin 300170,China;Respiratory Intensive Care Unit,Tianjin University Haihe Hospital,Tianjin 300350,China)

机构地区：[1]天津市第三中心医院重症医学科,天津300170 [2]天津大学海河医院呼吸重症监护室,天津300350

出　　处：《中华危重病急救医学》2022年第5期459-464,共6页Chinese Critical Care Medicine

基　　金：天津市科技计划项目(18ZXDBSY00100)。

摘　　要：目的分析新冠病毒奥密克戎变异株感染患者的流行病学和临床特征,同时对接种新冠疫苗是否对患者疾病严重程度及预后产生影响进行分析。方法采用前瞻性、单中心观察性研究方法,选择2022年1月8日至2月2日天津市第三中心医院新冠救治医疗队在天津市新冠肺炎定点医院连续收治的新冠病毒奥密克戎变异株感染患者的病例资料,分析患者的临床特点,以及患者是否接种新冠疫苗加强针对病情及转归的影响。收集数据包括流行病学、临床特征、实验室和影像学检查、治疗措施和临床结果,并进行组间比较。结果共纳入362例患者,其中加强接种组136例(37.57%)、常规接种组190例(52.49%)和未接种组36例(9.94%)。患者呈集中分布趋势,其中171例(47.24%)患者表现出家庭聚集发病,共涉及69个家庭。362例患者中,74例(20.44%)患者存在1种或1种以上基础疾病,主要是高血压(64例,17.68%)、糖尿病(23例,6.35%)、冠心病(18例,4.97%);215例(59.39%)患者存在1种或1种以上不适症状,主要是咳嗽(158例,43.65%)、咽部不适(154例,42.54%)和发热(136例,37.57%)。诊断分型为轻型194例(53.59%)、普通型165例(45.58%)、重型3例(0.83%)。患者入院时新冠病毒免疫球蛋白G(IgG)抗体滴度升高〔23.17(3.08,60.77)〕。患者均接受医学隔离,主要的治疗措施包括中医辨证(中成药或汤药)治疗265例(73.20%)、俯卧位治疗188例(51.93%)、低分子肝素抗凝治疗106例(29.28%)、胸腺法新免疫调节治疗21例(5.80%)、使用抗菌药物20例(5.52%)、经鼻高流量氧疗12例(3.31%)、使用糖皮质激素5例(1.38%)、无创机械通气1例(0.28%)、有创机械通气1例(0.28%)。362例患者均好转出院,无死亡病例,其中有12例(3.31%)患者入住重症监护病房(ICU)治疗;患者的病程中位数为13(10,15)d,住院时间中位数为13(11,15)d,核酸转阴时间中位数为13(10,15)d。与未接种组相比,加强接种组和常规接种组患�Objective To analyze the epidemiological and clinical characteristics of patients infected by novel coronavirus Omicron variant,and also to analyze whether vaccination against novel coronavirus has an impact on the severity and prognosis of Omicron patients.Methods A prospective,single-center observational study was conducted to collect data of consecutive patients with Omicron variant infection admitted to the designated hospital for coronavirus disease 2019(COVID-19)charged by Tianjin COVID-19 rescue medical team of Tianjin Third Central Hospital,from January 8 to February 2,2022.The clinical characteristics of the patients were analyzed,and the influence of whether the patients were inoculated with booster vaccination on the condition and outcome was analyzed.Data were collected including epidemiological,clinical features,laboratory and imaging examination,treatment measures and clinical outcomes,and difference between groups was analyzed.Results A total of 362 patients were included,including 136 cases(37.57%)in the booster group,190 cases(52.49%)in the routine vaccination group,and 36 cases(9.94%)in the unvaccinated group.There was a trend of concentrated distribution of patients,of which 171 cases(47.24%)patients showed family clustering,involving 69 families.Seventy-four cases(20.44%)of the 362 patients had one or more underlying diseases,mainly hypertension(64 cases,17.68%),diabetes mellitus(23 cases,6.35%),and coronary heart disease(18 cases,4.97%);215 patients(59.39%)had one or more discomfort symptoms,mainly cough(158 cases,43.65%),pharyngeal discomfort(154 cases,42.54%)and fever(136 cases,37.57%).The diagnostic typing was mild type in 194 cases(53.59%),moderate type in 165 cases(45.58%)and severe type in 3 cases(0.83%).The patients had elevated immunoglobulin G(IgG)antibody titers to the novel coronavirus on admission[23.17(3.08,60.77)].Patients were medically isolated and the main treatment measures included traditional Chinese medicine identification(Chinese medicine or tonics)in 265 cases(73.20%),p

关 键 词：奥密克戎 新型冠状病毒肺炎 疫苗 临床特征 

分 类 号：R563.1[医药卫生—呼吸系统]