接种不同疫苗伴基础疾病新冠病毒奥密克戎变异株感染患者的临床特征分析  

Analysis of clinical characteristics of patients with different vaccines and underlying diseases infected with novel coronavirus Omicron variant

作　　者：许华 王晶晶 高红梅[1] 王勇强[1] Xu Hua;Wang Jingjing;Gao Hongmei;Wang Yongqiang(Department of Critical Care Medicine,Key Laboratory for Critical Care Medicine of the Ministry of Health,Emergency Medicine Research Institute,Tianjin First Center Hospital,Tianjin 300192,China)

机构地区：[1]天津市第一中心医院重症医学科,国家卫健委危重病急救医学重点实验室,天津市急救医学研究所,天津300192

出　　处：《中华危重病急救医学》2022年第6期571-575,共5页Chinese Critical Care Medicine

基　　金：天津市医学重点学科建设项目(2021-492)。

摘　　要：目的分析接种不同疫苗且伴基础疾病的新型冠状病毒(新冠病毒)奥密克戎变异株感染患者的临床特征。方法收集天津市第一中心医院2022年1月21日至3月7日收治的430例新冠病毒奥密克戎变异株感染患者的临床资料,共筛选108例伴基础疾病的奥密克戎变异株感染患者入组,收集患者性别、年龄、体质量指数(BMI)、基础疾病史、接种疫苗情况(接种针次、接种疫苗类型)、临床症状、实验室检查指标、影像学资料、住院时间、核酸转阴时间、复阳及抗体滴度情况,分析接种灭活疫苗和腺病毒疫苗两组患者上述指标的差异。结果共纳入108例患者,其中93例接种灭活疫苗,15例接种腺病毒疫苗。两组患者性别、年龄、BMI、疾病分型、是否完成全程接种、是否接种加强针及基础疾病比较差异均无统计学意义;两组患者均有发热、干咳、咽痛、流涕等临床症状,但两组间比较差异均无统计学意义;两组患者实验室检测血常规和生化指标、C-反应蛋白(CRP)及胸部CT影像学检查结果比较差异也均无统计学意义。两组患者住院时间、核酸转阴时间、入住重症监护病房(ICU)情况、复阳情况和免疫球蛋白M(IgM)抗体滴度表达比较差异均无统计学意义,但腺病毒疫苗组免疫球蛋白G(IgG)抗体滴度明显高于灭活疫苗组(g/L:229.67±26.13比194.33±61.56,P=0.020)。灭活疫苗组接种加强针患者与接种腺病毒疫苗组接种加强针患者的实验室检查、住院时间、核酸转阴时间、复阳情况、新冠抗体滴度等比较差异均无统计学意义。结论接种灭活病毒疫苗和腺病毒疫苗对伴基础疾病奥密克戎变异株感染患者的保护力度相当,其中腺病毒疫苗接种患者康复1周后IgG抗体表达量高于灭活病毒疫苗接种患者。Objective To analyze the clinical characteristics of patients inoculated with different vaccines and underlying diseases,infected with the novel coronavirus Omicron variant.Methods The data of 430 patients infected with the novel coronavirus Omicron variant who were admitted to Tianjin First Center Hospital from January 21,2022 to March 7,2022 were collected.A total of 108 patients with Omicron variant infection with underlying diseases were selected and enrolled.The gender,age,body mass index(BMI),history of underlying diseases,vaccination status(vaccination times,vaccination type),clinical symptoms,laboratory test indicators,imaging data,hospitalization time,nucleic acid negative conversion time,re-positivity and antibody titer from the two groups of the patients were collected and analyzed.Results In the 108 patients,93 cases received inactivated vaccine and 15 cases received adenovirus vaccine.There was no statistically significant difference between the two groups in terms of gender,age,BMI,disease types,whether completed the fully vaccinated,whether had prime boost and underlying diseases.Both groups had fever,dry cough,sore throat,runny nose and other clinical symptoms,but there were no statistical difference between the two groups.There were no statistically significant differences in laboratory blood routine tests,biochemical indexes,C-reactive protein(CRP)level and the results of chest computed tomography(CT)imaging between the two groups.There were no statistically significant differences in hospitalization days,nucleic acid negative conversion time,whether admission to intensive care unit(ICU),turn re-positive on nucleic acid tests and immunoglobulin M(IgM)antibody titer expression between the two groups,but immunoglobulin G(IgG)antibody titer in adenovirus group was higher than that in inactivated group(g/L:229.67±26.13 vs.194.33±61.56,P=0.020).There were also no significant differences in laboratory examinations,hospitalization days,nucleic acid negative conversion time,turn re-positive on nucleic

关 键 词：新冠病毒奥密克戎变异株 灭活病毒疫苗 腺病毒疫苗 基础疾病 临床特征 

分 类 号：R186[医药卫生—流行病学] R563.1[医药卫生—公共卫生与预防医学]