2020年至2021年上海市新型冠状病毒与其他常见呼吸道病原体混合感染的特征  

Features of severe acute respiratory syndrome coronavirus 2 co-infected with other common respiratory pathogens in Shanghai City, 2020-2021

作　　者：邱琪 孔德川 滕峥[3] 周艳秋 陈洪友[3] 张曦[3] 陈健[2] 郑雅旭[1] 蒋先进 袁诗颖 吴寰宇[1] 潘浩 孙晓冬[1] Qiu Qi;Kong Dechuan;Teng Zheng;Zhou Yanqiu;Chen Hongyou;Zhang Xi;Chen Jian;Zheng Yaxu;Jiang Xianjin;Yuan Shiying;Wu Huanyu;Pan Hao;Sun Xiaodong(Institute of Infectious Disease Prevention and Control,Shanghai Municipal Center for Disease Control and Prevention,Shanghai 200336,China;Shanghai Institute of Preventive Medicine,Shanghai 200336,China;Department of Microbiology,Shanghai Municipal Center for Disease Control and Prevention,Shanghai 200336,China)

机构地区：[1]上海市疾病预防控制中心传染病防治所,上海200336 [2]上海市预防医学研究院,上海200336 [3]上海市疾病预防控制中心病原生物检定所,上海200336

出　　处：《中华传染病杂志》2023年第4期249-254,共6页Chinese Journal of Infectious Diseases

基　　金：上海市加强公共卫生体系建设三年行动计划(2020-2022年)优秀青年人才培养计划(GWV-10.2-YQ37);新型冠状病毒肺炎血清流行病学及感染传播风险研究(20JC1410200)

摘　　要：目的:分析上海市新型冠状病毒感染(COVID-19)患者新型冠状病毒(SARS-CoV-2)与其他常见呼吸道病原体混合感染的特征,为科学防控提供依据。方法:采用描述性流行病学方法。纳入2020年1月至2021年2月期间上海市报告的272例COVID-19患者,相关基础数据来源于中国疾病预防控制信息系统。收集纳入患者的临床资料,并采用多重反转录聚合酶链反应,对其就诊或入院时采集的SARS-CoV-2核酸阳性呼吸道标本进行22种常见呼吸道病原体的核酸检测。统计学分析采用独立样本t检验。结果:272例COVID-19患者中,15例(5.5%)存在SARS-CoV-2与其他呼吸道病原体混合感染,均为双重感染。合并感染的呼吸道病原体包括肠道病毒/鼻病毒3例,腺病毒、人偏肺病毒、冠状病毒NL63/HKU1各2例,冠状病毒229E、甲型H1N1流行性感冒病毒、副流感病毒Ⅰ型和呼吸道合胞病毒B型各1例;与肺炎支原体混合感染2例。272例COVID-19患者中,发热212例(77.9%),咳嗽117例(43.0%),乏力46例(16.9%),咽痛35例(12.9%)。混合感染组的白细胞计数为(6.8±1.7)×10^(9)/L,高于非混合感染组的(5.3±1.6)×10^(9)/L,差异有统计学意义(t=3.09,P=0.008)。结论:上海市COVID-19患者中存在一定比例的其他呼吸道病原体混合感染,以病毒为主,尤其是肠道病毒/鼻病毒。在诊疗过程中应注意联合用药,并进一步加强急性呼吸道感染的监测。Objective To analyze the features of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)co-infected with other common respiratory pathogens among coronavirus disease 2019(COVID-19)patients in Shanghai City,and to provide a reference for scientific prevention and control of COVID-19 and other respiratory infectious diseases.Methods Descriptive epidemiological approaches were used to analyze the data of COVID-19 reported cases in Shanghai City from January 2020 to February 2021 in the information system of Chinese Disease Prevention and Control.Clinical data of the participants were collected,and their SARS-CoV-2 nucleic acid-positive respiratory specimens were collected at the time of illness onset or admission.Multiplex reverse transcription-polymerase chain reaction(RT-PCR)was performed to detect the 22 respiratory pathogens.Independent-samples t test was used for statistical analysis.Results Of the 272 patients with COVID-19,15(5.5%)had co-infection of SARS-CoV-2 with other respiratory pathogens,all of which were double infection.There were three cases infected with enterovirus/rhinovirus,two of each with adenovirus,human metapneumovirus and coronavirus NL63/HKU1,and one of each with coronavirus 229E,influenza A virus H1N1,parainfluenza virus 1 and respiratory syncytial virus B.Two cases infected with Mycoplasma pneumoniae.Among the 272 COVID-19 patients,212(77.9%)had fever,117(43.0%)had cough,46(16.9%)had fatigue,and 35(12.9%)had sore throat.The white blood cell count of co-infection cases was higher than that of non-co-infection cases((6.8±1.7)×10^(9)/L vs(5.3±1.6)×10^(9)/L),and the difference was statistically significant(t=3.09,P=0.008).Conclusions There is a certain proportion of co-infection of SARS-CoV-2 with other respiratory pathogens among the COVID-19 cases in Shanghai City,mainly viral pathogens,especially enterovirus/rhinovirus.A rational combination of drugs was recommended to improve the cure rate.Surveillance of acute respiratory infection should be further strengthened as well.

关 键 词：新型冠状病毒 呼吸道病原体 混合感染 临床特征 

分 类 号：R51[医药卫生—内科学]