泉州市Omicron变异株BA.2感染普通型患者临床特征及影响核酸转阴时间的因素  

Clinical characteristics and factors affecting nucleic acid negative conversion time of moderate COVID-19 patients infected with Omicron variant BA.2 in Quanzhou City

作　　者：张洪玲 李才辉[1] 魏思灿[1] 黄玲 林天来[1] ZHANG Hong-ling;LI Cai-hui;WEI Si-can;HUANG Ling;LIN Tian-lai(Department of Critical Care Medicine,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou 362000,China)

机构地区：[1]福建医科大学附属泉州第一医院重症医学科,福建泉州362000

出　　处：《中国感染控制杂志》2022年第11期1096-1104,共9页Chinese Journal of Infection Control

基　　金：福建省自然科学基金卫生行业联合资金新上项目(2019J01597);泉州市医疗卫生领域指导性科技计划项目(2021N062S)。

摘　　要：目的观察泉州市奥密克戎(Omicron)变异株BA.2感染普通型新型冠状病毒肺炎(COVID-19)患者的临床特征,分析影响核酸转阴时间的因素。方法收集2022年3月13日—4月5日福建医科大学附属泉州第一医院收治的67例Omicron变异株BA.2感染普通型COVID-19患者的临床资料,回顾性分析其临床特征及新型冠状病毒(SARS-CoV-2)核酸转阴时间的影响因素。结果入组患者男女比例为1∶1.03,年龄为9~97(41.45±17.51)岁,35.82%患有基础疾病,83.58%接种了新冠疫苗。初诊时最常见临床症状为咳嗽(62.69%),其次为发热(32.84%)。白细胞计数降低、中性粒细胞百分比升高和淋巴细胞计数降低的比率分别为11.94%、7.46%、29.85%,天冬氨酸氨基转移酶、丙氨酸氨基转移酶、乳酸脱氢酶、肌酸激酶、肌酸激酶同工酶升高的比率分别为8.95%、10.45%、25.37%、14.93%、14.93%,C反应蛋白(CRP)、白细胞介素-6、血沉、降钙素原升高的比率分别为35.82%、71.64%、56.72%、4.48%,D-二聚体、肌酐、铁蛋白升高的比率分别为8.95%、28.36%、13.43%,46.27%的患者IgG抗体阳性。肺部CT以双下肺外周多发、散在病灶为主,斑片状高密度影及磨玻璃影多见,1.49%的患者出现少量双侧胸腔积液。10.45%的患者出现并发症,SARS-CoV-2核酸转阴时间平均(18.12±5.37)d,住院时间平均(19.45±5.41)d,所有患者均未进展为重型/危重型,全部治愈出院。有呼吸系统疾病、CRP升高为SARS-CoV-2核酸转阴时间延长的独立危险因素(均P<0.05)。结论泉州市Omicron变异株BA.2感染普通型COVID-19患者初诊临床症状较轻,咳嗽为最常见症状,部分合并基础疾病,绝大部分完成新冠疫苗接种,经积极治疗后预后良好。SARS-CoV-2核酸转阴时间较长,与呼吸系统疾病、CRP升高明显相关。Objective To observe the clinical characteristics of moderate coronavirus disease 2019(COVID-19)patients infected with Omicron variant BA.2 in Quanzhou City,and analyze risk factors for nucleic acid negative conversion time.Methods Clinical data of 67 moderate COVID-19 patients infected with Omicron variant BA.2 in Quanzhou First Hospital Affiliated to Fujian Medical University from March 13,2022 to April 5,2022 were collec-ted,clinical characteristics and influencing factors for nucleic acid negative conversion time were retrospectively analyzed.Results The male to female ratio of the enrolled patients was 1∶1.03,the age ranged from 9 to 97(41.45±17.51)years old,35.82%of patients had underlying diseases,and 83.58%received COVID-19 vaccine.The most common clinical symptom at the initial diagnosis was cough(62.69%),followed by fever(32.84%).The proportions of decreased white blood cell(WBC)count,increased neutrophil percentage and decreased lymphocyte count were 11.94%,7.46%and 29.85%respectively,the increased proportions of aspartate aminotransferase,alanine aminotransferase,lactate dehydrogenase,creatine kinase and creatine kinase isoenzyme were 8.95%,10.45%,25.37%,14.93%and 14.93%respectively,the increased proportions of C-reactive protein(CRP),interleukin-6,erythrocyte sedimentation rate and procalcitonin were 35.82%,71.64%,56.72%and 4.48%,respectively;the increased proportions of D-dimer,creatinine and ferritin were 8.95%,28.36%and 13.43%,respectively,46.27%of the patients were positive for IgG antibodies.Pulmonary CT mainly showed multiple and scattered lesions in the periphery of both lower lungs,patchy high-density shadow and ground glass shadow were more common,and 1.49%of patients had a small amount of bilateral pleural effusion.10.45%of the patients had complications,the average time of nucleic acid negative conversion of SARS-CoV-2 was(18.12±5.37)days,the average time of hospitalization was(19.45±5.41)days.None of patients progressed to severe/critical disease,all were cured and discharged from ho

关 键 词：新型冠状病毒肺炎 奥密克戎 变异株 临床特征 核酸转阴时间 

分 类 号：R181.3[医药卫生—流行病学]