Department of Hematology, Kochi Medical School, Kochi University, Japan.
Department of Respiratory Medicine and Allergology, Kochi Medical School, Kochi University, Japan.
Intern Med. 2023 May 1;62(9):1265-1271. doi: 10.2169/internalmedicine.1252-22. Epub 2023 Feb 15.
Objective Patients with hematological malignancies and solid organ tumors reportedly tend to have a more severe coronavirus disease 2019 (COVID-19) trajectory than do those with other diseases. We studied the clinical features and outcomes of nosocomial severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during the seventh wave of the pandemic. Methods This study retrospectively described the characteristics of COVID-19 clusters involving patients in the hematology/respirology ward of Kochi Medical School Hospital during the seventh wave of the pandemic of SARS-CoV-2. Patients A total of 40 individuals, including 25 patients and 15 healthcare workers, were studied. The diagnosis of SARS-CoV-2 infection was based on reverse transcription polymerase chain reaction performed on nasopharyngeal samples. Results Eleven patients had hematological diseases, and 14 had respiratory diseases. Most patients presented with a fever (n=19) and/or sore throat (n=10). Lower respiratory tract symptoms and pneumonia were rather infrequent, occurring in two patients. All patients received antivirals. The maximal severities were mild in 21 patients and moderate in 2. Two asymptomatic patients with SARS-CoV-2 infection did not develop symptoms of COVID-19. Cycle threshold values in nasopharyngeal samples were significantly lower in patients with COVID-19 than in those who were asymptomatic at the time of the diagnosis with SARS-CoV-2 infection. All SARS-CoV-2-infected inpatients recovered or did not develop symptoms of COVID-19. Conclusion COVID-19 vaccination, early or preemptive treatment with antivirals, and intrinsic changes in SARS-CoV-2 may have contributed to the more favorable outcomes in our series than in previously reported nosocomial clusters.
目的 据报道,血液系统恶性肿瘤和实体器官肿瘤患者的 2019 年冠状病毒病(COVID-19)病程比其他疾病患者更为严重。我们研究了第七波大流行期间医院获得性严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)感染的临床特征和结局。
方法 本研究回顾性描述了第七波 SARS-CoV-2 大流行期间高知医科大学医院血液科/呼吸科病房 COVID-19 群集患者的特征。
患者 共研究了 40 人,包括 25 名患者和 15 名医护人员。SARS-CoV-2 感染的诊断基于鼻咽样本的逆转录聚合酶链反应。
结果 11 名患者患有血液系统疾病,14 名患者患有呼吸系统疾病。大多数患者表现出发热(n=19)和/或咽痛(n=10)。下呼吸道症状和肺炎较为少见,仅发生在 2 名患者中。所有患者均接受了抗病毒治疗。21 名患者的严重程度为轻度,2 名患者为中度。2 名无症状 SARS-CoV-2 感染患者未出现 COVID-19 症状。鼻咽样本中的循环阈值在 COVID-19 患者中明显低于 SARS-CoV-2 感染时无症状的患者。所有 SARS-CoV-2 感染的住院患者均康复或未出现 COVID-19 症状。
结论 COVID-19 疫苗接种、早期或抢先使用抗病毒药物以及 SARS-CoV-2 的内在变化可能使我们的系列研究结果优于先前报告的医院获得性群集。