奥密克戎和德尔塔病例临床特征的比较  

Comparison of clinical features of Omicron and Delta cases

作　　者：朱绮霞 李燕姿[1] 郭乐倩 张姗姗 胡婷婷[1] 陈雨馨 李红霞[1,4] ZHU Qixia;LI Yanzi;GUO Leqian;ZHANG Shanshan;HU Tingting;CHEN Yuxin;LI Hongxia(Department of medical administration,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061;Department of Obstetrics and Gynecology,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061;Department of Radiotherapy,Xi’an Chest Hospital,Xi’an 710100;Department of gastroenterology,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China)

机构地区：[1]西安交通大学第一附属医院医务部,陕西西安710061 [2]西安交通大学第一附属医院妇产科,陕西西安710061 [3]西安市胸科医院放疗科,陕西西安710100 [4]西安交通大学第一附属医院消化内科,陕西西安710061

出　　处：《西安交通大学学报（医学版）》2022年第5期797-800,F0003,共5页Journal of Xi’an Jiaotong University（Medical Sciences）

摘　　要：目的比较奥密克戎和德尔塔病例的临床特征,为新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)的防治提供科学依据。方法采用病例对照研究方法,回顾性分析2021年12月至2022年1月西安市新冠肺炎定点救治医院收治的奥密克戎病例临床资料,以同期收治的德尔塔病例作为对照组,收集并比较两组患者的人口学资料、流行病学史、疫苗接种情况、临床特征、实验室检查、核酸及抗体水平、转归情况等。结果共纳入21例患者,奥密克戎患者5例,德尔塔病例16例。两组患者的平均年龄分别为(38.20±15.07)岁、(37.69±10.39)岁,末次疫苗接种至确诊时间间隔分别为(145.40±77.92)d、(159.00±99.74)d。首发临床症状,奥密克戎患者以咽部不适(3例,60%)、咳嗽咳痰(2例,40%)为主,德尔塔患者以咽部不适(5例,31.25%)、乏力(5例,31.25%)、咳嗽咳痰(4例,25%)为主。入院时实验室检查,60%的奥密克戎患者出现淋巴细胞降低和血沉升高,50%的德尔塔组患者出现血红蛋白升高。奥密克戎组ORFlab基因、N基因、E基因Ct值均低于德尔塔组,且E基因两组间差异有统计学意义(t=-2.711,P=0.024);两组IgG水平均升高。奥密克戎组SARS-CoV-2核酸转阴时间为(28.20±5.89)d,德尔塔组为(18.50±7.73)d,组间差异有统计学意义(t=2.565,P=0.019)。奥密克戎组住院时间为(30.60±4.88)d,德尔塔组为(22.13±7.81)d,组间差异有统计学意义(t=2.270,P=0.035)。结论奥密克戎患者首发症状以咽部不适、咳嗽咳痰为主,临床表现总体较轻,核酸检测Ct值较低,核酸转阴时间和转院时间均较长,潜在传染性更强,符合接种条件的人群应尽早完成全程接种和加强针接种,严格落实“四早”管理。Objective To compare the clinical features of Omicron and Delta cases,so as to provide scientific basis for the prevention and treatment of COVID-19.Methods The case-control study method was used to retrospectively analyze the clinical data of the Omicron cases admitted to the designated hospital for the treatment of COVID-19 in Xi’an from December 2021 to January 2022.and the Delta cases admitted during the same period were used as the control group.The demographic data,epidemiological history,vaccination status,clinical characteristics,laboratory tests,nucleic acid and antibody levels,and outcomes of patients in the two groups were collected and compared.Results A total of 21 patients were included in the study,5 were Omicron patients and 16 were Delta cases.The mean age of the patients in the two groups were(38.20±15.07)and(37.69±10.39)years,respectively.The time interval between the last vaccination and the diagnosis was(145.40±77.92)days and(159.00±99.74)days,respectively.For the initial symptoms,the patients with Omicron were mainly characterized by throat discomfort(3,60%),cough and sputum(2,40%),and the patients with Delta were mainly characterized by throat discomfort(5,31.25%),fatigue(5,31.25%),cough and sputum(4,25%).On admission,laboratory tests showed that 60%of Omicron patients had low lymphocytes and elevated erythrocyte sedimentation rate,and50%of patients in the delta group had elevated hemoglobin.The Ct values of ORFlab gene,N gene and E gene with Omicron were lower than those with Delta.And the difference of E gene between the two groups was statistically significant(t=-2.711,P=0.024).IgG antibody levels increased in both groups.The time for nucleic acid to turn negative with Omicron was(28.20±5.89)days,and it was(18.50±7.73)days with Delta,and the difference between the groups was statistically significant(t=2.565,P=0.019).The length of hospitalization with Omicron was(30.60±4.88)days,and that with Delta was(22.13±7.81)days,and the difference was statistically significant(t=2.270,P=0

关 键 词：新型冠状病毒肺炎 奥密克戎 德尔塔 临床特征 

分 类 号：R563.1[医药卫生—呼吸系统]