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[广东省新型冠状病毒肺炎无症状感染者流行病学特征]

[Epidemiological characteristics of asymptomatic infection cases of COVID-19 in Guangdong province].

作者信息

Xie S L, Huang J H, Liu J, Liu J, Long Q S, Xie X, Liao Y H, Tang L L, Liang W J, Zhong H J, Li Y

机构信息

Institute for HIV/AIDS Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.

Public Health Emergency Preparedness and Response Division, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2020 Sep 10;41(9):1406-1410. doi: 10.3760/cma.j.cn112338-20200423-00633.

Abstract

To analyze the epidemiological characteristics of the cases firstly reported as "asymptomatic infection of COVID-19" in Guangdong province. The follow-up observation method was used to continuously track and observe the cases firstly reported as "asymptomatic patients with COVID-19" in Guangdong province from January 14 to March 31, 2020. The epidemiological data of the cases were collected to analyze their epidemiological characteristics, outcome and influencing factors. From January 14 to March 31, 2020, a total of 325 cases were firstly reported as "asymptomatic infections of COVID-19" in Guangdong province. The epidemic curve of asymptomatic infection cases was similar to that of confirmed cases, and it had two peaks. The first peak was from January 27 to February 5, and the second peak was from March 17 to March 26. Of the 325 cases, 184 (56.6%) were subsequently converted to confirmed cases. These cases were defined as incubation period asymptomatic infection cases. The age median of the cases was 40 years, and 93.5% (172/184) of the cases showed symptoms within 3 days after the first positive nucleic acid tests were conducted, and 141 (43.4%) of the 325 cases remained asymptomatic status until they were cured and discharged. They were inapparent infection cases, accounting for 8.6% (141/1 642) of those diagnosed with COVID-19 in Guangdong province during the same period. The age median of inapparent infection cases was 27 years. The median of the interval between the first positive nucleic acid test and discharge was 14 days. Up to 90.8% (138/141) of the inapparent infection cases were discharged for centralized medical observation within 28 days. The longest interval between the first positive nucleic acid test and the last positive nucleic acid test was 73 days. The positive rate of nucleic acid test was 0.3% in close contacts of inapparent infection cases and 2.2% in close contacts of incubation period asymptomatic infection cases. There were significant differences in age distribution and source of infection between incubation period asymptomatic infection cases and inapparent infection cases (<0.05). Old age was the risk factor for the conversion of firstly reported asymptomatic infection cases to confirmed cases. Compared with the 0-19-year-old group, The patients aged 40-59 years and 60 years and above were more likely to become confirmed cases. The (95) values were 2.730 (1.380-5.402) and 5.302 (2.199-12.783), and P values were 0.004 and 0.000, respectively. People being infected in China were more likely to become confirmed cases (=7.121, =0.000). There were asymptomatic infection cases among patients diagnosed with COVID-19. The infectiousness of incubation period asymptomatic infection cases might be stronger than that of inapparent infection cases. The proportion of younger cases among asymptomatic infection cases was higher than that of the confirmed cases. Old age and domestic infection were the risk factors for the conversion of asymptomatic infection cases to confirmed cases, to which more attention should be paid. Further serological investigations are needed to provide a basis for the development of COVID-19 prevention and control strategies.

摘要

分析广东省首次报告为“新型冠状病毒肺炎无症状感染者”病例的流行病学特征。采用随访观察法,对2020年1月14日至3月31日广东省首次报告的“新型冠状病毒肺炎无症状感染者”病例进行连续跟踪观察。收集病例的流行病学资料,分析其流行病学特征、转归及影响因素。2020年1月14日至3月31日,广东省共首次报告325例“新型冠状病毒肺炎无症状感染者”。无症状感染者的流行曲线与确诊病例相似,有两个高峰。第一个高峰为1月27日至2月5日,第二个高峰为3月17日至3月26日。325例中,184例(56.6%)随后转为确诊病例。这些病例被定义为潜伏期无症状感染者。病例的年龄中位数为40岁,184例中有93.5%(172/184)在首次核酸检测阳性后3天内出现症状,325例中有141例(43.4%)直至治愈出院一直处于无症状状态。他们为隐性感染病例,占同期广东省确诊新型冠状病毒肺炎病例的8.6%(141/1642)。隐性感染病例的年龄中位数为27岁。首次核酸检测阳性至出院的时间间隔中位数为14天。141例隐性感染病例中,高达90.8%(138/141)在28天内集中医学观察出院。首次核酸检测阳性至最后一次核酸检测阳性的最长间隔为73天。隐性感染病例密切接触者的核酸检测阳性率为0.3%,潜伏期无症状感染病例密切接触者的核酸检测阳性率为2.2%。潜伏期无症状感染病例与隐性感染病例在年龄分布和感染来源方面存在显著差异(<0.05)。高龄是首次报告的无症状感染者转为确诊病例的危险因素。与0~19岁组相比,40~59岁及60岁及以上患者更易成为确诊病例。(95)值分别为2.730(1.380~5.402)和5.302(2.199~12.783),P值分别为0.004和0.000。在国内感染的人更易成为确诊病例(=7.121,=0.000)。确诊新型冠状病毒肺炎患者中存在无症状感染病例。潜伏期无症状感染病例的传染性可能强于隐性感染病例。无症状感染病例中年轻病例的比例高于确诊病例。高龄和国内感染是无症状感染病例转为确诊病例的危险因素,应予以更多关注。需要进一步开展血清学调查,为制定新型冠状病毒肺炎防控策略提供依据。

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