新型冠状病毒Omicron变异株引起的续发率及影响因素研究  

Analysis on the secondary attack rates of SARS-CoV-2 Omicron variant and the associated factors

作　　者：尚庆香 许可[2] 戴启刚[2] 黄昊頔 胡建利[2] 邹鑫 陈立凌[3] 魏叶[4] 李海朋[5] 甄茜[6] 蔡伟 王寅 鲍倡俊 Shang Qingxiang;Xu Ke;Dai Qigang;Huang Haodi;Hu Jianli;Zou Xin;Chen Liling;Wei Ye;Li Haipeng;Zhen Qian;Cai Wei;Wang Yin;Bao Changjun(School of Public Health,Nanjing Medical University,Nanjing 211166,China;Department of Acute Infectious Disease Control and Prevention,Jiangsu Provincial Center for Disease Control and Prevention,Nanjing 210009,China;Department of Acute Infectious Disease Control and Prevention,Suzhou Center for Disease Control and Prevention,Suzhou 215004,China;Department of Acute Infectious Disease Control and Prevention,Nantong Center for Disease Control and Prevention,Nantong 226007,China;Department of Acute Infectious Disease Control and Prevention,Lianyungang Center for Disease Control and Prevention,Lianyungang 222003,China;Department of Acute Infectious Disease Control and Prevention,Changzhou Center for Disease Control and Prevention,Changzhou 213003,China;Department of Acute Infectious Disease Control and Prevention,Suqian Center for Disease Control and Prevention,Suqian 223899,China;Department of Acute Infectious Disease Control and Prevention,Yangzhou Center for Disease Control and Prevention,Yangzhou 225007,China)

机构地区：[1]南京医科大学公共卫生学院,南京211166 [2]江苏省疾病预防控制中心急性传染病防制所,南京210009 [3]苏州市疾病预防控制中心急性传染病防制科,苏州215004 [4]南通市疾病预防控制中心急性传染病防制科,南通226007 [5]连云港市疾病预防控制中心急性传染病防制科,连云港222003 [6]常州市疾病预防控制中心急性传染病防制科,常州213003 [7]宿迁市疾病预防控制中心急性传染病防制科,宿迁223899 [8]扬州市疾病预防控制中心急性传染病防制科,扬州225007

出　　处：《中华预防医学杂志》2023年第10期1550-1557,共8页Chinese Journal of Preventive Medicine

基　　金：江苏省卫生健康委重点项目(ZD2021037);江苏省卫生健康委员会(M2020026)。

摘　　要：目的分析新型冠状病毒Omicron变异株引起的续发率(SAR)及影响因素。方法选取2022年2—4月江苏省本土社会面发现的新型冠状病毒Omicron变异株感染病例和密切接触者,纳入328例社会面原发病例和40 146名密切接触者,并将密切接触者中7 d集中隔离医学观察期间核酸检测结果转为阳性者定义为续发病例。收集人口学和临床特征等相关信息,采用多因素logistic回归模型分析SAR的影响因素。结果 328名原发病例共报告续发病例1 285例,SAR为3.2%(95%CI:3.0%~3.4%)。328例原发病例中,男性占61.9%(203例),年龄M(Q1,Q3)为38.5(27,51)岁;1 285例续发病例中,男性占59.1%(759例),年龄M(Q1,Q3)为34(17,52)岁。多因素logistic回归模型分析结果显示,原发病例为男性(OR=1.632,95%CI:1.418~1.877)、年龄20岁以下(OR=1.766,95%CI:1.506~2.072)和60岁及以上(OR=1.869,95%CI:1.476~2.365)、感染BA.2毒株分支(OR=2.906,95%CI:2.388~3.537)、病例分型是确诊普通型(OR=2.572,95%CI:2.036~3.249)和确诊轻型(OR=1.717,95%CI:1.486~1.985)的SAR风险更高;密切接触者年龄在20岁以下(OR=2.604,95%CI:2.250~3.015)和60岁及以上(OR=1.287,95%CI:1.052~1.573)、接触方式为同住接触(OR=27.854,95%CI:23.470~33.057)的SAR风险更高。结论 Omicron变异株原发病例性别、年龄、感染毒株分支、病例分型,以及密切接触者的年龄和接触方式是SAR的影响因素。Objective To evaluate the secondary attack rates of the SARS-CoV-2 Omicron variant and the associated factors.Methods A total of 328 primary cases and 40146 close contacts of the SARS-CoV-2 Omicron variant routinely detected in local areas of Jiangsu Province from February to April 2022 were selected in this study,and those with positive nucleic acid test results during 7 days of centralized isolation medical observation were defined as secondary cases.The demographic information and clinical characteristics were collected,and the secondary attack rate(SAR)and the associated factors were analyzed by using a multivariate logistic regression model.Results A total of 1285 secondary cases of close contacts were reported from 328 primary cases,with a SAR of 3.2%(95%CI:3.0%-3.4%).Among the 328 primary cases,males accounted for 61.9%(203 cases),with the median age(Q1,Q3)of 38.5(27,51)years old.Among the 1285 secondary cases,males accounted for 59.1%(759 cases),with the median age(Q1,Q3)of 34(17,52)years old.The multivariate logistic regression model showed that the higher SAR was observed in the primary male cases(OR=1.632,95%CI:1.418-1.877),younger than 20 years old(OR=1.766,95%CI:1.506-2.072),≥60 years old(OR=1.869,95%CI:1.476-2.365),infected with the BA.2 strain branch(OR=2.906,95%CI:2.388-3.537),the confirmed common cases(OR=2.572,95%CI:2.036-3.249),and confirmed mild cases(OR=1.717,95%CI:1.486-1.985).Meanwhile,the higher SAR was observed in the close contacts younger than 20 years old(OR=2.604,95%CI:2.250-3.015),≥60 years old(OR=1.287,95%CI:1.052-1.573)and exposure for co-residence(OR=27.854,95%CI:23.470-33.057).Conclusion The sex and age of the primary case of the Omicron variant,the branch of the infected strain,case severity of the primary case,as well as the age and contact mode of close contacts are the associated factors of SAR.

关 键 词：新型冠状病毒 Omicron变异株 续发率 横断面研究 

分 类 号：R511[医药卫生—内科学]