中国60岁以下新型冠状病毒感染者临床表现的队列研究  

Clinical features of COVID-19 in patients under 60 years:a cohort study

作　　者：牟玮[1] 王瑞华[1] 黄宇虹[1] 孙凤[2] 雒明池 张莉[1] 田金徽[3] 陈竑瑞 张俊华[4] 邢永发 谷旭放[1] 孙金霞[1] 王保和[5] 郑文科[4] 宛佳玮 胡本泽 Mu Wei;Wang Ruihua;Huang Yuhong;Sun Feng;Luo Mingchi;Zhang Li;Tian Jinhui;Chen Hongrui;Zhang Junhua;Xing Yongfa;Gu Xufang;Sun Jinxia;Wang Baohe;Zheng Wenke;Wan Jiawei;Hu Benze(Department of Clinical Pharmacology,Second Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300250,China;Department of Epidemiology and Biostatistics,School of Public Health,Peking University,Beijing 100191,China;Evidence-based Medicine Center,School of Basic Medical Sciences,Lanzhou University,Lanzhou 730000,China;Institute of Traditional Chinese Medicine Research,Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China;First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300381,China;School of Postgraduate Studies,Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China)

机构地区：[1]天津中医药大学第二附属医院临床药理中心,天津300250 [2]北京大学公共卫生学院流行病与卫生统计学系,北京100191 [3]兰州大学基础医学院循证医学中心,兰州730000 [4]天津中医药大学中医药研究院,天津301617 [5]天津中医药大学第一附属医院,天津300381 [6]天津中医药大学研究生院,天津301617

出　　处：《国际流行病学传染病学杂志》2023年第4期239-245,共7页International Journal of Epidemiology and Infectious Disease

基　　金：国家重点研发计划(2021YFC1712902、2021YFC1712900)。

摘　　要：目的了解2022年12月中国60岁以下COVID-19患者的临床表现特征。方法采用队列研究设计,于2022年12月14—27日,通过在线问卷调查收集COVID-19患者发病时与转阴后的临床表现、确诊和转阴时间、使用药物等信息。感染1个月后电话随访患者的临床表现及转归情况(中国临床试验注册中心注册号:ChiCTR2200066736)。采用SAS 9.4对人口学特征、临床症状分布、转阴时间及服药情况进行描述性流行病学分析,比较服药与未服药组临床症状特征的差异。结果本次研究共收集全国各地有效问卷1257份。60岁以下COVID-19患者首发症状以发热(66.43%,835/1257)和咽痛(10.26%,129/1257)为主。COVID-19患者感染阳性期平均经历6.00(5.00,8.00)个症状,主要为上呼吸道感染症状;青壮年组(18~40岁)头疼的比例为79.35%(903/1138),高于其他组别。人群平均转阴时间需6.00(4.00,8.00)d。感染1个月后最常见的临床症状为咳嗽(30.50%,147/482),其次为咯痰(13.28%,64/482)。患者中有74.78%(940/1257)使用了药物,服药组与未服药组在感染阳性期和随访期临床症状差异均无统计学意义(χ^(2)=11.279,P=0.257;χ^(2)=6.509,P=0.688)。结论2022年12月中国COVID-19疫情高发期间,患者主要表现为发热、咳嗽、浑身酸疼、头疼等上呼吸道感染症状,1个月后患者仍有咳嗽、咯痰等不适。由于研究人群以青壮年、非重症者为主,结果外推的适宜性尚需论证。ObjectiveTo understand the clinical manifestations of COVID-19 in patients under 60 in December 2022.MethodsFrom December 14 to 27,2022,data on clinical presentations at onset and after nucleic acid/antigen conversion,date of diagnosis and recovery and medicine use were collected by online questionnaire surveys in a cohort study.One month after diagnosis,eligible participants were followed up on phones for persisting symptoms and health status(Chinese Clinical Trial Register:ChiCTR2200066736).SAS 9.4 was used for epidemiological descriptive analysis of demographic characteristics,clinical presentations,time to recovery and medicine use.The differences of clinical presentations were compared between medication group and non-medication group.ResultsA total of 1257 valid questionnaires were collected nationwide.Initial symptoms in COVID-19 patients under 60 were fever(66.43%,835/1257)and sore throat(10.26%,129/1257).These patients usually had 6.00(5.00,8.00)symptoms during the period of positive SARS-CoV-2 infection,and the primary symptoms were upper respiratory tract infections.The proportion of headache in patients of 18-40 was 79.35%(903/1138),which was higher than other groups.It took 6.00(4.00,8.00)days for nucleic acid/antigen conversion.The most common persisting symptom one month after diagnosis was cough(30.50%,147/482),followed by expectoration(13.28%,64/482).Among these patients,74.78%(940/1257)used medicine.There was no statistically significant difference in the clinical presentations during the period of positive SARS-CoV-2 infection and follow-up between medication group and non-medication group(χ^(2)=11.279,P=0.257;χ^(2)=6.509,P=0.688).ConclusionsThe COVID-19 surge occurred in December 2022 caused mainly upper respiratory tract infection including fever,cough,body aches,headache,etc.One month after diagnosis,cough and expectoration persist.However,the cohort includes young participants who have mild symptoms,that limits the generalizability of the research findings.

关 键 词：新型冠状病毒感染 临床表现 队列研究 发热 咽痛 

分 类 号：R511[医药卫生—内科学]