河南省入境超14天首次核酸阳性和出院后复检核酸阳性新冠肺炎感染者分析  

Analysis of COVID-19 cases tested positive 14 days later after the entry and re-positive after discharge in Henan Province

作　　者：潘静静[1] 范威 王艺康 王莹莹 王文华 李亚飞 王若琳[1] 其木格[1] 王海峰[1] 叶莹[1] 黄学勇[1] PAN Jing-jing;FAN Wei;WANG Yi-kang;WANG Ying-ying;WANG Wen-hua;LI Ya-fei;WANG Ruo-lin;QI Mu-ge;WANG Hai-feng;YEYing;HUANG Xue-yong(Institute for Infectious Disease Prevention and Control,Henan Province Center for Disease Control and Prevention,Zhengzhou,Henan 450016,China)

机构地区：[1]河南省疾病预防控制中心传染病预防控制所,河南郑州450016 [2]河南省疾病预防控制中心行政办公室,河南郑州450016

出　　处：《现代预防医学》2022年第24期4519-4523,共5页Modern Preventive Medicine

基　　金：河南省医学科技攻关计划省部共建项目(SBGJ202001003);河南省医学科技攻关计划联合共建项目(LHGJ20210144,LHGJ20220174);河南省科技厅重大专项(211100311000);河南省中青年卫生健康科技创新领军人才培训项目(YXKC2020006)。

摘　　要：目的分析河南省入境超14 d首次核酸检测阳性和出院后核酸复测阳性(复阳)的境外输入新冠肺炎感染者特征。方法将河南省2020年3月10日—2022年3月14日境外输入752例新冠肺炎感染者作为研究对象,收集其流行病学、实验室检测等信息,用χ^(2)检验和秩和检验进行统计分析,描述入境超14 d检测阳性和复阳病例的特点。结果收集到684例感染者入境及核酸检测时间,入境超14 d首次核酸检测阳性感染者共20例(2.92%),其中无症状感染者19例,确诊病例1例;男性19例,女性1例;跨省活动18例;完成全程接种7例;年龄中位数为40.5(30.25,48.5)岁;住院时长中位数为17(15.25,25)d。入境超14 d检测阳性病例中男性构成高于14 d内阳性病例中男性构成(χ^(2)=4.463,P=0.035),年龄大于后者(Z=-2.265,P=0.024),疫苗全程接种率低于后者(P<0.001),无症状感染者占比高于后者(χ^(2)=4.687,P=0.030)。752例感染者中复阳15例,复阳率为1.99%。另收集到10例在第一入境点治愈后返回河南复阳感染者,共25例。首次核酸阳性治愈出院到复阳时间间隔在1~297 d之间,中位数为13(3.25,26.75)d;复阳时ORF1ab基因CT值中位数为35.05(32.00,36.44),N基因中位数为35.62(32.91,36.55);发现复阳时集中隔离17例,居家隔离4例,自由活动4例;首次核酸阳性诊断为无症状感染者12例,确诊病例13例;复阳诊断为无症状感染者22例,确诊病例3例;复阳病例中首次诊断为确诊病例的比例高于非复阳病例(χ^(2)=6.223,P=0.013);复阳病例未造成二代传播。结论入境超14 d检出阳性者更多为无症状感染者,复阳病例核酸CT值较高,首诊确诊病例更易出现复阳,未发现入境复阳病例造成二代传播。Objective To analyze the characteristics of imported coronavirus disease 2019(COVID-19)cases inbound above14 days and re-positive patients in Henan and explore the influence factors,to provide prevention and control guidance.Methods The epidemiological data and laboratory tests information of 752 imported COVID-19 cases in Henan from March10,2020 to March 14,2022 were collected.Chi-square test and Rank sum test were used to describe the characteristics of over 14 days tested positive after the entry and re-positive patients and analyze the influencing factors.Results A total of684 cases were collected,and 20 cases(2.92%)were positive for nucleic acid test for the first time more than 14 days after entry.In total 19 cases were asymptomatic infection,one was confirmed case,19 cases were males,one case was female,18cases had interprovincial activity,and 7 cases completed the vaccinations.The median age was 40.5 years(30.25,48.5),and the median length of hospitalization was 17 days(15.25,25).Compared with positive cases inbound within 14 days,those over14 days showed to have a greater proportion of men(χ^(2)=4.463,P=0.035),older age(Z=-2.265,P=0.024),lower immunization coverage rate for whole-course(P<0.001),and a higher proportion of asymptomatic infections(χ^(2)=4.687,P=0.030).The proportion of asymptomatic infection was higher than that of the latter(asymptomatic infection).Among the 752 cases,15 cases were re-positive,and the re-positive rate was 1.99%.Another 10 re-positive cases who were cured at the first entry point and returned to Henan Province were collected.For the 25 re-positive cases,the interval between discharge from hospital when firstly confirmed and re-positive date was 1 to 297 days,with a median of 13(3.25,26.75)days.The median(P25,P75)of the cycle threshold(CT)value for ORF1ab gene was 35.05(32.00,36.44),and that for N gene was 35.62(32.91,36.55)of the re-positive.There were 17 cases under quarantine and 4 cases were free activity when they were tested re-positive.Of the 25 re-positive cases,1

关 键 词：新冠肺炎 境外输入病例 入境超14 d检测阳性 复阳 

分 类 号：R563.1[医药卫生—呼吸系统] R181.3[医药卫生—内科学]