新型冠状病毒奥密克戎亚型感染临床随访研究  

Clinical follow-up study of SARS-CoV-2 Omicron infection

作　　者：康晓宇 张琳[3] 王亮亮 严瑞 王九萍 陈章乾 KANG Xiaoyu;ZHANG Lin;WANG Liangliang;YAN Rui;WANG Jiuping;CHEN Zhangqian(The First Affiliated Hospital of Air Force Military Medical University,Xi'an,Shaanxi 710032,China;The Fourth Unit of Third Branch,Fangcang Shelter Hospital of National Exhibition and Convention Center,Shanghai 201702,China;Central Medical District of Chinese PLA General Hospital,Beijing 100032,China)

机构地区：[1]空军军医大学附属医院,陕西西安710032 [2]国家会展中心(上海)方舱医院三分院四分队,上海201702 [3]中国人民解放军总医院京中医疗区,北京100032

出　　处：《上海预防医学》2024年第1期25-29,共5页Shanghai Journal of Preventive Medicine

基　　金：国家自然科学基金项目(82003152);上海国展中心方舱医院第三分院新型冠状病毒肺炎防控专项课题(2022YH-1029,2022YH-1030)。

摘　　要：【目的】观察无症状和轻症奥密克戎变异株感染患者的病毒转阴时间和转阴持续时间。【方法】收集2022年4月9日—5月20日在国家会展中心(上海)方舱医院第三分院5F-B区收治的感染奥密克戎变异株新型冠状病毒(COVID-19)的244例患者临床资料。分析患者的人口统计学和临床数据信息。主要观察结果为COVID-19核酸转阴时间。采用单因素和多因素Cox风险模型确定核酸转阴时间的独立危险因素。【结果】新型冠状病毒RNA转阴持续时间中位数为9 d(7~12 d)。患者确诊感染后的第5、7、10和14天内核酸阳性的患者分别占68.4%、47.1%、20.1%和5.7%。Kaplan-Meier曲线显示,高血压患者的核酸转阴时间中位数为12 d(10~14 d),而非高血压患者为9 d(7~11 d),年龄≥60岁患者为11 d(9~13 d),<60岁患者为9 d(7~11 d)。多变量Cox回归分析显示,仅高血压是核酸转阴的相关因素(RR=1.60;95%CI:1.03~2.49,P=0.036)。【结论】奥密克戎亚型感染的无症状或轻症患者中20.1%在感染10 d时仍会出现病毒核酸阳性的情况。SARS-CoV-2核酸转阴时间的独立相关因素是高血压病。[Objective]To observe the clinical course and explore the risk factors for SARS-CoV-2 RNA negative conversion duration(NCD)in asymptomatic and mild-symptomatic patients infected with the SARS-CoV-2 Omicron variant.[Methods]Clinical data were collected from 244 confirmed cases of corona virus disease(COVID-19)with Omicron variant infection admitted to a temporal makeshift hospital in Shanghai from April 9,2022 to May 20,2022.Demographic and clinical data were analyzed,with a primary focus on the time of COVID-19 nucleic acid conversion.Univariate and multivariate Cox regression analysis were used to determine identify risk factors associated with NCD.[Results]The median duration of negative RNA conversion was 9 days(ranged 7‒12 days).The percentage of patients with positive nucleic acid results on the 5th,7th,10th,and 14th days after confirmed infection was 68.4%,47.1%,20.1%,and 5.7%,respectively.Kaplan-Meier curves indicated a median nucleic acid conversion time of 12 days(ranged 10‒14 days)for patients with hypertension,9 days(ranged 7‒11 days)in patients without hypertension,and 11 days(ranged 9‒13 days)for patients aged≥60 years,and 9 days(ranged 7‒11 days)for patients aged<60 years.Multivariate Cox regression analysis showed that only hypertension was an independent risk factor of NCD(RR=1.60;95%CI:1.03‒2.49,P=0.036).[Conclusion]In asymptomatic or mildly symptomatic patients infected with the Omicron variant,20.1%patients continue to exhibit positive viral nucleic acid on the 10th days of infection.The independent risk factor associated with the conversion of SARS-CoV-2 nucleic acid to negative is hypertension.

关 键 词：新型冠状病毒感染 奥密克戎亚型 核酸转阴时间 危险因素 

分 类 号：R184[医药卫生—流行病学]