新冠病毒奥密克戎变异株感染的核酸转阴时间分析  

Analysis of nucleic acid negative conversion time of novel coronavirus omicron mutant infection

作　　者：刘天[1,2] 阮德欣 王丽 曾玉洁 黄继贵 赵婧[3] LIU Tian;RUAN De-xin;WANG Li;ZENG Yu-jie;HUANG Ji-gui;ZHAO Jing(Infectious Disease Prevention and Control Institute of Jingzhou Center for Disease Control and Prevention,Jingzhou,Hubei 434000,China;不详)

机构地区：[1]荆州市疾病预防控制中心传染病防治所,湖北荆州434000 [2]长江大学公共卫生研究中心,湖北荆州434023 [3]中国疾病预防控制中心,北京102206

出　　处：《现代预防医学》2023年第21期3866-3870,共5页Modern Preventive Medicine

基　　金：荆州市2021年度医疗卫生科技计划(2021HC20)。

摘　　要：目的 分析新冠病毒感染奥密克戎变异株上呼吸道标本核酸转阴时间,为了解新冠病毒感染奥密克戎变异株传染期提供参考。方法 以2022年11月1日—2023年1月10日湖北省荆州市某单位新冠病毒感染者为研究对象,收集感染者年龄、性别、新冠病毒疫苗接种史、2022年流感疫苗接种史以及发病日期、首次核酸检测阳性日期以及往后隔日核酸检测结果。发病日期或首次核酸阳性较早者定义为第0 d;连续2次(至少间隔24 h)核酸检测阴性定义为核酸转阴。采用生存分析计算转阴时间,Cox比例风险回归进行亚组比较。对定点收治医院感染者进行基因测序,监测荆州市流行毒株。结果 共102例新冠病毒感染者纳入研究,男女性别比0.96:1,年龄以40岁以上人群(65例,63.73%)居多,所有感染者既往均接种3剂次灭活疫苗,73例2022年7—8月接种4价流感疫苗。研究期间35名感染者进行基因测序结果显示均为Omicron BA.5.2变异株。感染者发病(或核酸检测首次阳性)5 d后核酸阳性率为97%。核酸转阴中位时间为12 d(95%CI:12~14 d),18 d后核酸均转阴。不同性别和年龄组感染者核酸转阴时间存在差异(P<0.05)。女性、男性感染者核酸转阴中位时间分别为12 d(95%CI:11~14 d)、13 d(95%CI:12~15 d)。40岁及以下感染者核酸转阴中位时间为11 d(95%CI:10~12 d),发病(或核酸检测首次阳性后)16 d后核酸均转阴;40岁以上感染者核酸转阴中位时间为14 d(95%CI:12~14 d),18 d后核酸均转阴。是否接种流感疫苗感染者核酸转阴时间差异无统计学意义(P>0.05)。结论新冠病毒感染奥密克戎变异株发病(或核酸检测首次阳性)后核酸转阴时间中位数为12 d,18 d内均转阴。年龄较长男性感染者转阴时间长。Objective To analyze the nucleic acid negative conversion time of upper respiratory tract samples of novel coronavirus infected with Omicron mutant,to provide reference for understanding the infection period of novel coronavirus infected with Omicron mutant.Methods Novel coronavirus infected individuals at an institution in Jingzhou city,Hubei Province from November 1,2022 to January 10,2023 were selected as the research object.Age,sex,novel coronavirus vaccination history,influenza vaccination history,onset date in 2022,the positive date of the first nucleic acid test,and the results of nucleic acid test the next day were collected.The onset date or the first nucleic acid positive result was defined as the 0 day,and the negative nucleic acid test for 2 consecutive times(at least 24 hours interval)was defined as nucleic acid negative.Survival analysis was used to calculate the negative time,and Cox proportional hazard regression was used for subgroup comparison.The infected patients in designated hospitals were sequenced and the epidemic strains in Jingzhou were monitored.Results A total of 102 cases of novel coronavirus infection were included in the study,with a sex ratio of 0.96:1,and most of them were over 40 years old(65 cases,63.73%).All infected patients were vaccinated with 3 doses of inactivated vaccine and 73 cases were vaccinated with 4-valent influenza vaccine from July to August in 2022.The results of gene sequencing of 35 infected patients during the study showed that all of them were infected with OmicronBA.5.2 mutants.Five days after the onset of the infection(or the first positive nucleic acid test),the nucleic acid positive rate was 97%.The median time of nucleic acid negative conversion was 12 days(95%CI:12 days to 14 days),and all nucleic acids turned negative after 18 days.There were significant differences in nucleic acid negative conversion time among different sex and age groups(P<0.05).The median time of nucleic acid negative conversion in female and male infected patients was 12 days(95%

关 键 词：新冠病毒 奥密克戎 核酸转阴时间 生存分析 

分 类 号：R511.7[医药卫生—内科学] R186[医药卫生—临床医学]