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17 例感染 SARS-CoV-2 奥密克戎变异株的输入性病例的流行病学特征。

Epidemiological characteristics of 17 imported patients infected with SARS-CoV-2 Omicron variant.

机构信息

Department of Medical Administration, First Hospital of Changsha, Changsha 410005.

Department of Infectious Diseases, First Hospital of Changsha, Changsha 410005.

出版信息

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2022 Mar 28;47(3):344-351. doi: 10.11817/j.issn.1672-7347.2022.220040.

Abstract

OBJECTIVES

With the continuous generation of new variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the pressure of epidemic prevention and control continues to increase in China. Omicron with stronger infectiousness, immune escape ability and repeated infection ability spread to many countries and regions around the world in a short period of time. China has also successively reported cases of imported Omicron infections. This study aims to understand the epidemiological characteristics of Omicron variant via analyzing the epidemiological characteristics of imported patients with Omicron in Hunan Province, and to provide reference for preventing and controlling the imported epidemics.

METHODS

The clinical data of imported patients with coronavirus disease 2019 admitted to Hunan Province from December 16 to December 31, 2021 were retrospectively collected. The epidemiological information, general information, clinical classification, clinical symptoms, vaccination status, and lung CT were analyzed. Nasopharyngeal swabs and blood samples were collected. Virus nucleic acid was detected by magnetic beads method using SARS-CoV-2 detection kit. Ct values of gene and gene were compared between asymptomatic infected patients and confirmed patients. The specific IgM and IgG antibodies were detected by chemiluminescence assay using SARS-CoV-2 IgM test kit and SARS-CoV-2 IgG test kit, respectively. Ct values of IgM and IgG antibodies were compared between asymptomatic infected patients and confirmed patients.

RESULTS

Seventeen patients with Omicron variant infection were treated in Hunan, including 15 confirmed patients (5 common type and 10 mild type) and 2 asymptomatic infection patients. The 17 patients were all Chinese, they were generally young, and 16 were male. There were 9 patients with diseases. Of them 3 patients had respiratory diseases. All 17 patients had completed the whole process of vaccination, but only one person received a booster shot of SARS-CoV-2 vaccine. The clinical manifestations of the patients were mild, mainly including dry/painful/itchy throat, cough, and fatigue. The total protein and creatine in the asymptomatic infection and confirmed cases infected with Omicron variant were all within the normal range, but other biochemical indicators were abnormal. There were the significant differences in C-reactive protein and fibrinogen between asymptomatic infection and confirmed patients (both <0.05). There were more patients with elevated C-reactive protein in confirmed patients than without confirmed ones. The detection rate of specific IgM and IgG antibodies on admission was 100%, and there was no significant difference in the specific antibody levels between asymptomatic infection and confirmed patients (>0.05). There were no significant differences in Ct values of gene and gene (21.35 and 18.39 vs 19.22 and 15.67) between the asymptomatic infection and the confirmed patients (both >0.05). Only 3 patients had abnormal lung CT, showing a small amount of patchy and cord-like shadows. One of them had no abnormality on admission but had pulmonary lesions and migratory phenomenon after admission.

CONCLUSIONS

The patients with Omicron variant tend to be young people and have milder clinical symptoms, but the viral load is high and the infectiveness is strong. Therefore, the timely identification and effective isolation and control for asymptomatic infections and confirmed patients with mild symptoms are extremely important. In terms of epidemic prevention and control, the government still needs to strengthen the risk control of overseas input, adhere to normalized epidemic prevention and control measures, to effectively control the source of infection, cut off the route of transmission, and protect vulnerable people.

摘要

目的

随着严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)新变异株的不断出现,中国疫情防控压力持续增大。具有更强传染性、免疫逃逸能力和重复感染能力的奥密克戎变异株在短时间内迅速传播至全球多个国家和地区,中国也相继报告了输入性奥密克戎感染病例。本研究旨在通过分析湖南省输入性奥密克戎变异株感染者的流行病学特征,了解奥密克戎变异株的流行特征,为防控输入性疫情提供参考。

方法

回顾性收集 2021 年 12 月 16 日至 12 月 31 日湖南省收治的输入性新型冠状病毒肺炎患者的临床资料,分析其流行病学信息、一般资料、临床分型、临床症状、疫苗接种情况、肺部 CT 等。采集鼻咽拭子和血液标本,采用 SARS-CoV-2 检测试剂盒,磁珠法检测病毒核酸。比较无症状感染者和确诊患者 基因和 基因 Ct 值。采用 SARS-CoV-2 IgM 试剂盒和 SARS-CoV-2 IgG 试剂盒,化学发光法检测特异性 IgM 和 IgG 抗体,比较无症状感染者和确诊患者的 IgM 和 IgG 抗体 Ct 值。

结果

湖南省共收治 17 例奥密克戎变异株感染者,包括 15 例确诊病例(普通型 5 例,轻型 10 例)和 2 例无症状感染者。17 例患者均为中国籍,均为男性,年龄均较轻,均为 18~57 岁,其中 9 例有基础疾病,3 例患有呼吸系统疾病。17 例患者均全程接种疫苗,但仅 1 人接种了 SARS-CoV-2 疫苗加强针。患者临床表现均较轻,主要表现为咽干/痛/痒、咳嗽、乏力。无症状感染者和确诊病例感染奥密克戎变异株后总蛋白和肌酸激酶均在正常范围内,但其他生化指标异常。无症状感染者和确诊患者的 C 反应蛋白和纤维蛋白原差异均有统计学意义(均<0.05),确诊患者中 C 反应蛋白升高者比例高于无症状感染者。入院时特异性 IgM 和 IgG 抗体的检测率均为 100%,无症状感染者和确诊患者的特异性抗体水平差异均无统计学意义(均>0.05)。无症状感染者和确诊患者的 基因和 基因 Ct 值(21.35 和 19.22 比 18.39 和 15.67)差异均无统计学意义(均>0.05)。仅 3 例患者肺部 CT 异常,呈少量斑片状及条索状影,其中 1 例入院时无异常,入院后出现肺部病变并呈迁徙性改变。

结论

奥密克戎变异株感染者以年轻人为主,临床症状较轻,但病毒载量较高,传染性较强。因此,及时发现并对无症状感染者和轻症确诊患者进行有效隔离和管控极为重要。在疫情防控方面,政府仍需加强境外输入风险管控,坚持常态化疫情防控措施,有效控制传染源,切断传播途径,保护易感人群。

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