Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
J Microbiol Immunol Infect. 2022 Dec;55(6 Pt 1):1036-1043. doi: 10.1016/j.jmii.2022.08.007. Epub 2022 Aug 17.
BACKGROUND/PURPOSE: Clinical characteristics of patients in the first community outbreak of coronavirus disease 2019 (COVID-19) by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant B.1.1.7 in Taiwan have not been characterized.
SARS-CoV-2 positive specimens from inpatients between May 7 and June 15 in 2021were screen for SARS-CoV-2 B.1.1.7 lineage by VirSNiP assay. Clinical characteristics were reviewed and compared with those from Feb 1 to April 30, 2020 and from Jan 1 to March 31, 2022.
One hundred forty-one inpatients from May 7 to June 15, 2021 infected with SARS-CoV-2 B.1.1.7 lineage were included. The major presenting symptoms were fever (88.7%) and cough (59.6%). Incidence of relevant complications including pulmonary embolism, simultaneous infections with bacteria, virus, and fungi were 0.7%, 12.8%, 13.5%, and 2.1%, respectively. Old age, high Charlson comorbidity index, short of breath, and initial critical illness were independently associated with 28-day mortality (all p < 0.05). In comparison to COVID-19 inpatients from Feb 1 to April 30, 2020, patients from the outbreak by SARS-CoV-2 B.1.1.7 lineage were older, more severe in disease condition, higher mortality but less obvious initial presenting symptoms. After implementation of nationwide vaccination campaign in the next half year of 2021, COVID-19 inpatients from Jan 1 to March 31 in 2022 indicated less severe diseases than those infected with SARS-CoV-2 B.1.1.7 lineage.
COVID-19 inpatients by SARS-CoV-2 variant B.1.1.7 with old age, multiple comorbidities, and more severe disease conditions were associated with increased mortality. Vaccination for this vulnerable populations may be helpful.
背景/目的：在台湾，由严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）变异株 B.1.1.7 引起的 2019 年冠状病毒病（COVID-19）的首次社区暴发的患者的临床特征尚未确定。
对 2021 年 5 月 7 日至 6 月 15 日期间住院患者的 SARS-CoV-2 阳性标本进行 VirSNiP 检测，以筛选 SARS-CoV-2 B.1.1.7 谱系。回顾并比较了与 2020 年 2 月 1 日至 4 月 30 日以及 2022 年 1 月 1 日至 3 月 31 日的数据。
共纳入 141 例 5 月 7 日至 6 月 15 日期间感染 SARS-CoV-2 B.1.1.7 谱系的住院患者。主要表现症状为发热（88.7%）和咳嗽（59.6%）。肺栓塞、细菌、病毒和真菌感染同时发生的相关并发症的发生率分别为 0.7%、12.8%、13.5%和 2.1%。高龄、高 Charlson 合并症指数、呼吸急促和初始危重症与 28 天死亡率独立相关（均 P<0.05）。与 2020 年 2 月 1 日至 4 月 30 日的 COVID-19 住院患者相比，SARS-CoV-2 B.1.1.7 谱系感染者年龄更大，病情更严重，死亡率更高，但初始症状不明显。在 2021 年下半年实施全国性疫苗接种运动后，2022 年 1 月 1 日至 3 月 31 日的 COVID-19 住院患者的病情比感染 SARS-CoV-2 B.1.1.7 谱系的患者轻。
年龄较大、合并多种疾病和病情较重的 SARS-CoV-2 变异株 B.1.1.7 感染者 COVID-19 住院患者死亡率增加。为这一脆弱人群接种疫苗可能会有所帮助。
