Feng Quansheng, Wang Zhiyong, Yu Hongzhi, Shi Lixia, Xu Lei
Intensive Care Unit, the Third Central Hospital of Tianjin, Tianjin 300170, China.
Respiratory Intensive Care Unit, Tianjin University Haihe Hospital, Tianjin 300350, China. Corresponding author: Xu Lei, Email:
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2022 May;34(5):459-464. doi: 10.3760/cma.j.cn121430-20220223-00167.
To analyze the epidemiological and clinical characteristics of patients infected by novel coronavirus Omicron variant, and also to analyze whether vaccination against novel coronavirus has an impact on the severity and prognosis of Omicron patients.
A prospective, single-center observational study was conducted to collect data of consecutive patients with Omicron variant infection admitted to the designated hospital for coronavirus disease 2019 (COVID-19) charged by Tianjin COVID-19 rescue medical team of Tianjin Third Central Hospital, from January 8 to February 2, 2022. The clinical characteristics of the patients were analyzed, and the influence of whether the patients were inoculated with booster vaccination on the condition and outcome was analyzed. Data were collected including epidemiological, clinical features, laboratory and imaging examination, treatment measures and clinical outcomes, and difference between groups was analyzed.
A total of 362 patients were included, including 136 cases (37.57%) in the booster group, 190 cases (52.49%) in the routine vaccination group, and 36 cases (9.94%) in the unvaccinated group. There was a trend of concentrated distribution of patients, of which 171 cases (47.24%) patients showed family clustering, involving 69 families. Seventy-four cases (20.44%) of the 362 patients had one or more underlying diseases, mainly hypertension (64 cases, 17.68%), diabetes mellitus (23 cases, 6.35%), and coronary heart disease (18 cases, 4.97%); 215 patients (59.39%) had one or more discomfort symptoms, mainly cough (158 cases, 43.65%), pharyngeal discomfort (154 cases, 42.54%) and fever (136 cases, 37.57%). The diagnostic typing was mild type in 194 cases (53.59%), moderate type in 165 cases (45.58%) and severe type in 3 cases (0.83%). The patients had elevated immunoglobulin G (IgG) antibody titers to the novel coronavirus on admission [23.17 (3.08, 60.77)]. Patients were medically isolated and the main treatment measures included traditional Chinese medicine identification (Chinese medicine or tonics) in 265 cases (73.20%), prone treatment in 188 cases (51.93%), anticoagulation with low-molecular heparin in 106 cases (29.28%), immunomodulatory therapy with thymofacine in 21 cases (5.80%), antimicrobial drugs in 20 cases (5.52%), transnasal high-flow oxygen therapy in 12 cases (3.31%), glucocorticoids in 5 cases (1.38%), non-invasive mechanical ventilation in 1 case (0.28%), and invasive mechanical ventilation in 1 case (0.28%). A total of 362 patients were discharged with no deaths, of which 12 patients (3.31%) were admitted to the intensive care unit (ICU). The median duration of illness was 13 (10, 15) days, the median length of hospitalization was 13 (11, 15) days, and the median time to nucleic acid conversion was 13 (10, 15) days. Compared with the unvaccinated group, the IgG antibody titers of patients in the booster and routine vaccination groups [41.49 (20.32, 81.38), 19.94 (2.33, 49.25) vs. 0.16 (0.07, 1.94)] and the proportion of mild patients [66.91% (91/136), 48.94% (93/190) vs. 27.28% (10/36)] were higher, which were also higher in the booster vaccination group than in the conventional vaccination group (all P < 0.05). Compared to the conventional and booster vaccination groups, the unvaccinated group had a higher proportion of severe patients [5.56% (2/36) vs. 0.53% (1/190), 0 (1/136)], longer time to nucleic acid conversion [days: 15 (11, 16) vs.12 (10, 15), 13 (11, 15)], and longer disease duration [days: 15 (11, 16) vs. 12 (10, 15), 13 (11, 15)], and a higher percentage of ICU admissions [16.67% (6/36) vs. 2.63% (5/190), 0.74% (1/136)], with statistically significant differences among the three groups (all P < 0.05).
Omicron variant is extremely infectious with aggregated onset, but its clinical symptoms are mild. The vaccine, especially the booster vaccination, remains effective in preventing severe-stage progression and improving prognosis in patients with Omicron variant infection.
分析新型冠状病毒奥密克戎变异株感染患者的流行病学及临床特征，分析接种新型冠状病毒疫苗是否对奥密克戎患者的病情严重程度及预后产生影响。
采用前瞻性、单中心观察性研究，收集2022年1月8日至2月2日天津市第三中心医院天津市新冠肺炎救治医疗队收治的指定医院中连续的奥密克戎变异株感染患者的数据。分析患者的临床特征，分析患者是否接种加强针疫苗对病情及转归的影响。收集的数据包括流行病学、临床特征、实验室及影像学检查、治疗措施及临床转归，并分析组间差异。
共纳入362例患者，其中加强针组136例（37.57%），常规接种组190例（52.49%），未接种组36例（9.94%）。患者呈聚集性分布趋势，其中171例（47.24%）患者表现为家庭聚集性，涉及69个家庭。362例患者中74例（20.44%）患有1种或多种基础疾病，主要为高血压（64例，17.68%）、糖尿病（23例，6.35%）和冠心病（18例，4.97%）；215例患者（59.39%）有1种或多种不适症状，主要为咳嗽（158例，43.65%）、咽部不适（154例，42.54%）和发热（136例，37.57%）。诊断分型为轻型194例（53.59%），中型165例（45.58%），重型3例（0.83%）。患者入院时新型冠状病毒免疫球蛋白G（IgG）抗体滴度升高[23.17（3.08，60.77）]。患者接受医学隔离，主要治疗措施包括中药辨治（中药或滋补剂）265例（73.20%）、俯卧位治疗188例（51.93%）、低分子肝素抗凝106例（29.28%）、胸腺法新免疫调节治疗21例（5.80%）、抗菌药物20例（5.52%）、经鼻高流量氧疗12例（3.31%）、糖皮质激素5例（1.38%）、无创机械通气1例（0.28%）、有创机械通气1例（0.28%）。362例患者均治愈出院，无死亡病例，其中12例（3.31%）患者入住重症监护病房（ICU）。疾病中位病程为13（10，15）天，中位住院时间为13（11，15）天，核酸转阴中位时间为13（10，15）天。与未接种组相比，加强针组和常规接种组患者的IgG抗体滴度[41.49（20.32，81.38），19.94（2.33，49.25） vs. 0.16（0.07，1.94）]及轻型患者比例[66.91%（91/136），48.94%（93/190） vs. 27.28%（10/36）]更高，且加强针组高于常规接种组（均P<0.05）。与常规接种组和加强针组相比，未接种组重型患者比例更高[5.56%（2/36） vs. 0.53%（1/190），0（1/136）]，核酸转阴时间更长[天：15（11，16） vs.12（10，15），13（11，1
