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老年是感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2)奥密克戎变异株且有灭活疫苗接种史患者发生肺炎的独立危险因素。

Old Age is an Independent Risk Factor for Pneumonia Development in Patients with SARS-CoV-2 Omicron Variant Infection and a History of Inactivated Vaccine Injection.

作者信息

Tong Xuecheng, Huang Zeyu, Zhang Xiujun, Si Guocan, Lu Huifen, Zhang Wei, Xue Yuan, Xie Weibin

机构信息

Institute of Hepatology, the Third People's Hospital of Changzhou, Changzhou, People's Republic of China.

Department of Infectious Diseases, the Third People's Hospital of Changzhou, Changzhou, People's Republic of China.

出版信息

Infect Drug Resist. 2022 Sep 21;15:5567-5573. doi: 10.2147/IDR.S380005. eCollection 2022.

Abstract

OBJECTIVE

Analyzing the risk factors for pneumonia development in breakthrough cases with a history of inactivated vaccine injection is important. The present study aimed to investigate the risk factors for pneumonia development during Omicron variant infection.

DESIGN AND METHODS

The clinical data were retrospectively collected from 187 patients who previously received inactivated vaccine and were infected by the Omicron variant.

RESULTS

Among the 187 patients, 73 had 2 doses of inactivated vaccine injection and the remaining 114 had 3 doses; 19 patients had pneumonia at admission. The univariate logistic analysis showed that age, baseline platelet count, D-dimer level, and CD8 T lymphocyte count were associated with pneumonia development at admission. The multivariate analysis showed that only age was the independent risk factor for pneumonia development (odds ratio = 1.046, 95% confidence interval: 1.003-1.091, = 0.04). With an optimal cutoff value of 46, 4.4% (4/91) patients in the age <46 years group and 15.63% (15/96) patients in the age ≥46 years group had pneumonia ( = 6.454, = 0.01). Moreover, age negatively correlated with CD8 T cell count, B cell count, and albumin and uric acid levels (all < 0.01), while age positively correlated with the glucose level ( < 0.01).

CONCLUSION

Old age was the only independent risk factor for pneumonia development in patients with Omicron variant infection and a history of inactivated vaccine injection.

摘要

目的

分析有灭活疫苗接种史的突破性病例中肺炎发生的危险因素很重要。本研究旨在调查奥密克戎变异株感染期间肺炎发生的危险因素。

设计与方法

回顾性收集187例既往接种过灭活疫苗且感染奥密克戎变异株患者的临床资料。

结果

187例患者中,73例接种了2剂灭活疫苗,其余114例接种了3剂;19例患者入院时患有肺炎。单因素逻辑回归分析显示,年龄、基线血小板计数、D-二聚体水平和CD8 T淋巴细胞计数与入院时肺炎的发生有关。多因素分析显示,只有年龄是肺炎发生的独立危险因素(比值比=1.046,95%置信区间:1.003-1.091,P=0.04)。年龄的最佳截断值为46岁,年龄<46岁组4.4%(4/91)的患者和年龄≥46岁组15.63%(15/96)的患者患有肺炎(P=6.454,P=0.01)。此外,年龄与CD8 T细胞计数、B细胞计数、白蛋白和尿酸水平呈负相关(均P<0.01),而年龄与血糖水平呈正相关(P<0.01)。

结论

高龄是有奥密克戎变异株感染史且接种过灭活疫苗患者肺炎发生的唯一独立危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7462/9512030/28fbad6b77b8/IDR-15-5567-g0001.jpg

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