应注意当前重症新型冠状病毒感染的新特点  

New characteristics of COVID-19 caused by the Omicron variant in Guangzhou

作　　者：程璘令[1] 李时悦[1] 钟南山[1] Cheng Linling;Li Shiyue;Zhong Nanshan(The First Affiliated Hospital of Guangzhou Medical University,National Respiratory Medicine Center,National Clinical Research Center for Respiratory Diseases,State Key Laboratory of Respiratory Diseases,Guangzhou Institute of Respiratory Health,Guangzhou 510120,China)

机构地区：[1]广州医科大学附属第一医院呼吸与危重症医学科、国家呼吸医学中心、国家呼吸系统疾病临床医学研究中心、呼吸疾病国家重点实验室、广州呼吸健康研究院,广州510120

出　　处：《中华结核和呼吸杂志》2023年第5期441-443,共3页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：2022年底至2023年初广州地区新型冠状病毒感染住院患者的毒株主要为奥密克戎BA.5.2(91.4%),合并感染除了常见的院内感染病原体(如肺炎克雷伯菌),特别需关注曲霉感染。奥密克戎株感染可引起病毒性脓毒症,导致预后更差。重症新型冠状病毒感染不等于重症肺炎,临床上需综合考虑肺部影像和其他系统的情况。合并新型冠状病毒感染的糖尿病患者并没有从糖皮质激素治疗中获益,这些患者使用糖皮质激素需要慎重。We investigated the types of novel coronavirus strains present during the Omicron epidemic from late 2022 to early 2023,COVID-19 co-infections with other pathogens,and clinical characteristics of patients with novel coronavirus infections.Adult patients hospitalized due to SARS CoV-2 infection in six hospitals in Guangzhou city were included in the study from November 2022 to February 2023.Clinical information was collected and analyzed,and bronchoalveolar lavage fluid was obtained for pathogen detection using a variety of techniques,including standard methods and mNGS,tNGS.The results showed that the main strain circulating in Guangzhou was Omicron BA.5.2,and the overall detection rate of potentially pathogenic pathogens combined with Omicron COVID-19 infection was 49.8%.In patients with severe COVID-19 infection,special attention should be paid to aspergillosis and combined Mycobacterium tuberculosis infection.In additon,Omicron strain infection could cause viral sepsis,which led to a worse prognosis for COVID-19 patients.Diabetic patients with SARS-CoV-2 infection did not benefit from glucocorticoid treatment,and caution was necessary when using glucocorticoids.These findings highlighted some new features of severe Omicron coronavirus infection that should be noted.

关 键 词：重症肺炎 冠状病毒感染 糖皮质激素 曲霉感染 肺炎克雷伯菌 脓毒症 合并感染 肺部影像 

分 类 号：R511[医药卫生—内科学]