重庆市新型冠状病毒二次感染者流行病学特征分析  

Epidemiological characteristics of SARS-CoV-2 secondary infection in Chongqing

作　　者：赵寒[1] 漆莉[1] 熊宇[1] 杨琳 吴维东 龙江[1] Zhao Han;Qi Li;Xiong Yu;Yang Lin;Wu Weidong;Long Jiang(Institute for Infectious Disease Control and Prevention,Chongqing Municipal Center for Disease Control and Prevention,Chongqing 400042,China)

机构地区：[1]重庆市疾病预防控制中心传染病防制所,重庆400042

出　　处：《国际流行病学传染病学杂志》2024年第1期18-22,共5页International Journal of Epidemiology and Infectious Disease

基　　金：重庆市卫生健康委应急科研项目(2023NCPZX03)。

摘　　要：目的了解重庆市SARS-CoV-2二次感染者的流行病学及临床特征,为优化COVID-19防控策略提供参考依据。方法选取2020年1月至2022年10月国家传染病监测报告管理系统中重庆市报告的2416例SARS-CoV-2感染者作为调查对象,并通过现场或电话调查他们在2022年11月至2023年1月期间的二次感染状况,内容包括人口学特征、SARS-CoV-2核酸检测结果、抗原检测结果、第二次感染相关症状及诊疗信息、疫苗接种相关信息等,通过重庆市病原体检测系统查询核酸检测信息,通过重庆市免疫规划信息管理系统查询疫苗接种信息,统计分析二次感染率和临床特征。结果共1971例既往SARS-CoV-2感染者接受调查,接受率81.58%(1971/2416)。明确二次感染率9.22%(181/1964),粗略二次感染率20.40%(402/1971)。奥密克戎变异株、德尔塔变异株和原始毒株既往感染者二次感染率差异有统计学意义(χ^(2)=481.163,P<0.001);96.02%(386/402)的二次感染者出现症状,15.96%(64/402)的二次感染者入院诊疗,1.49%(6/402)的二次感染者住院治疗,无重症死亡;咳嗽(59.33%,229/386)和发热(54.15%,209/386)为主要症状;与第一次感染间隔时间在1年及以上(12~<24个月:OR=9.879,95%CI:4.822~20.244;≥24个月:OR=17.489,95%CI:12.708~24.070)、20~<60岁(OR=2.860,95%CI:1.742~4.697)为发生粗略二次感染的危险因素,接种2剂次以上疫苗(2剂:OR=0.468,95%CI:0.220~0.997;3剂:OR=0.414,95%CI:0.210~0.815;4剂:OR=0.142,95%CI:0.038~0.534)为保护性因素。结论重庆市不同特征人群的SARS-CoV-2二次感染率差异较大,年龄和职业的感染差异显示与社会活跃度和积极保护措施有关,造成二次感染发生的主要原因是SARS-CoV-2变异毒株的突破性和感染间隔时间。SARS-CoV-2在不断变异过程中发生的重复感染的风险还存在多变性,应持续开展相关监测。Objective To understand the epidemiological and clinical characteristics of patients with secondary infection of SARS-CoV-2,and to provide reference for optimizing the strategy of prevention and control of COVID-19.Methods A total of 2416 COVID-19 cases reported in Chongqing from January 2020 to October 2022 were selected as the study subjects.Field or telephone surveys were conducted on their secondary infection status from November 2022 to January 2023,including demographic characteristics,results of nucleic acid testing,antigen testing results,symptoms and diagnosis information related to the second infection,vaccine-related information,etc.The nucleic acid testing information was obtained from Chongqing pathogen detection system,and vaccination information was obtained from the immunization program information management system of Chongqing.The prevalence of secondary infection and clinical characteristics were statistically analyzed.Results A total of 1971 prior COVID-19 individuals were investigated,with a response rate of 81.58%(1971/2416).The confirmed secondary infection rate was 9.22%(181/1964),and the crude rate was 20.40%(402/1971).There was a statistically significant difference in the secondary infection rates among individuals previously infected with Omicron variant,Delta variant,and original strain(χ^(2)=481.163,P<0.001).Among the secondary infection cases,96.02%(386/402)presented symptoms,15.96%(64/402)were admitted to hospital,1.49%(6/402)were hospitalized with no severe cases or deaths.The main symptoms were cough(59.33%,229/386)and fever(54.15%,209/386).An interval of 1 year or longer since the first infection(12-<24 months:OR=9.879,95%CI:4.822-20.244;≥24 months:OR=17.489,95%CI:12.708-24.070)and age between 20 and 60 years(OR=2.860,95%CI:1.742-4.697)were risk factors for secondary infection,while two or more doses of vaccine(2 doses:OR=0.468,95%CI:0.220-0.997;3 doses:OR=0.414,95%CI:0.210-0.815;4 doses:OR=0.142,95%CI:0.038-0.534)was a protective factor.Conclusions There is a significant dif

关 键 词：新型冠状病毒感染 奥密克戎变异株 二次感染 流行病学特征 

分 类 号：R511[医药卫生—内科学] R181.3[医药卫生—临床医学]