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日本全科诊所中感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2)N501Y变异株患者的临床特征

Clinical Characteristics of Patients with SARS-CoV-2 N501Y Variants in General Practitioner Clinic in Japan.

作者信息

Hanafusa Mariko, Kuramochi Jin, Ishihara Katsutoshi, Honda Makiko, Nawa Nobutoshi, Fujiwara Takeo

机构信息

Department of Global Health Promotion, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo 113-8510, Japan.

Kuramochi Clinic Interpark, Utsunomiya City, Tochigi 321-0114, Japan.

出版信息

J Clin Med. 2021 Dec 14;10(24):5865. doi: 10.3390/jcm10245865.

Abstract

The clinical characteristics of patients with N501Y mutation in SARS-CoV-2 variants (N501YV) is not fully understood, especially in the setting of general practice. In this retrospective cohort study, COVID-19 patients admitted to one general practitioner clinic between 26 March and 26 May 2021 were retrospectively analyzed. The characteristics, clinical symptoms and radiological findings before treatment were compared between N501YV and wild-type 501N. Twenty-eight patients were classified as wild-type 501N and 24 as N501YV. The mean (±standard deviation) age was 37.4 (±16.1) years, with no significant difference between groups. Among clinical symptoms, prevalence of fever of 38 degrees Celsius (°C) or higher was significantly higher in the N501YV group than in the wild-type 501N group ( = 0.001). Multivariate analysis showed that fever of 38 °C or higher remained significantly associated with N501YV (adjust odds ratio [aOR]: 6.07, 95% confidence interval [CI]: 1.68 to 21.94). For radiological findings, the lung involvement area was significantly larger in patients infected with N501YV ( = 0.013). In conclusion, in the N501YV group, fever of 38 °C or higher and extensive pneumonia were more frequently observed compared to the wild-type 501N group. There was no significant difference in terms of other demographics and clinical symptoms.

摘要

严重急性呼吸综合征冠状病毒2变体(N501YV)中N501Y突变患者的临床特征尚未完全明确,尤其是在全科医疗环境中。在这项回顾性队列研究中,对2021年3月26日至5月26日期间入住一家全科诊所的新冠肺炎患者进行了回顾性分析。比较了N501YV组和野生型501N组治疗前的特征、临床症状和影像学表现。28例患者被分类为野生型501N,24例为N501YV。平均(±标准差)年龄为37.4(±16.1)岁,两组间无显著差异。在临床症状方面,N501YV组中体温达到或超过38摄氏度(℃)的发热患病率显著高于野生型501N组( = 0.001)。多因素分析显示,体温达到或超过38℃仍与N501YV显著相关(调整优势比[aOR]:6.07,95%置信区间[CI]:1.68至21.94)。对于影像学表现,感染N501YV的患者肺部受累面积显著更大( = 0.013)。总之,与野生型501N组相比,N501YV组中体温达到或超过38℃以及广泛肺炎更为常见。在其他人口统计学和临床症状方面无显著差异。

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