奥密克戎变异株引起的轻症和普通型 COVID-19 患者核酸转阴的影响因素。
Influencing factors of nucleic acid negative conversion in patients with mild and common COVID-19 induced by the Omicron variant of SARS-COV-2.
机构信息
1. Graduate School, Jiangxi University of Chinese Medicine, Nanchang 330004, China.
2. Department of Nephrology, the 908th Hospital of PLA Joint Logistic Support Force, Nanchang 330002, China.
出版信息
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2022 Dec 25;51(6):731-737. doi: 10.3724/zdxbyxb-2022-0640.
OBJECTIVE
To observe the clinical characteristics of mild and common COVID-19 patients infected with the Omicron variant, and to analyze related factors affecting the time to negative conversion of viral nucleic acid detection.
METHODS
Clinical data of 1781 patients with coronavirus disease 2019 (COVID-19) admitted to a cabin hospital in Shanghai from April 12 to May 26, 2022, were retrospectively analyzed, including age, gender, height, weight, clinical symptoms, comorbid diseases, COVID-19 vaccination, treatment, and nucleic acid negative conversion time. Univariate and multivariate logistic regression analyses were used to analyze the influencing factors of nucleic acid negative conversion time.
RESULTS
Among the 1781 patients, 995 were male and 786 were female, with a median age of 39 (30, 52) years. There were 727 patients (40.8%) with overweight and obesity [body mass index (BMI) > 24 kg/cm ) and 413 patients (23.2%) had comorbid diseases. 205 cases (11.5%) were not vaccinated while 1576 cases were vaccinated. There were 1233 cases (69.2%) with one or more symptoms. The main clinical symptoms were cough (60.3%), expectoration (50.4%) and fever (36.9%). 1444 cases (81.0%) were treated with Chinese medicine, 78 cases (4.4%) were treated with western medicine, 14 cases (0.8%) were treated with integrated Chinese and western medicine, and 245 cases (13.8%) did not receive any medical treatment. All patients improved and were discharged. The median nucleic acid negative conversion time was 10.3 (7.4, 12.4) d. Univariate and multivariate analysis showed that, age ≥ 60 years ( ＝1.537, 95% : 1.116 - 2.115, <0.01), BMI > 24 kg/cm ( ＝1.344, 95% : 1.106 - 1.634, <0.01 ) and hypertension ( ＝1.518, 95% : 1.094 - 2.106, <0.05) were independent risk factors for prolonged nucleic acid negative conversion. COVID-19 vaccination ( =0.548, 95% : 0.398 - 0.755, <0.01) was a protective factor, that is, vaccination shortened the time for the nucleic acid test to become negative.
CONCLUSIONS
The symptoms of the Omicron variant infection were relatively mild and occult. Age ≥ 60 years old, comorbid hypertension, no vaccination and BMI > 24 kg/cm are independent influencing factors for prolonged nucleic acid negative conversion.
目的
观察感染奥密克戎变异株的轻症和普通型 COVID-19 患者的临床特征，并分析影响病毒核酸检测转阴时间的相关因素。
方法
回顾性分析 2022 年 4 月 12 日至 5 月 26 日上海市方舱医院收治的 1781 例 COVID-19 患者的临床资料，包括年龄、性别、身高、体重、临床症状、合并症、COVID-19 疫苗接种、治疗及核酸转阴时间等。采用单因素和多因素 logistic 回归分析核酸转阴时间的影响因素。
结果
1781 例患者中，男 995 例，女 786 例，中位年龄 39（30，52）岁。超重或肥胖[体质指数（BMI）＞24kg/cm]727 例（40.8%），合并症 413 例（23.2%）。未接种疫苗 205 例（11.5%），接种疫苗 1576 例（88.5%）。有 1233 例（69.2%）出现 1 种或多种症状，主要症状为咳嗽（60.3%）、咳痰（50.4%）和发热（36.9%）。1444 例（81.0%）接受中药治疗，78 例（4.4%）接受西药治疗，14 例（0.8%）接受中西医结合治疗，245 例（13.8%）未接受任何治疗。所有患者均好转出院。核酸转阴中位时间为 10.3（7.4，12.4）d。单因素和多因素分析显示，年龄≥60 岁（ ＝1.537，95%CI：1.116～2.115，＜0.01）、BMI＞24kg/cm （ ＝1.344，95%CI：1.106～1.634，＜0.01）和高血压（ ＝1.518，95%CI：1.094～2.106，＜0.05）是核酸转阴时间延长的独立危险因素，COVID-19 疫苗接种（ ＝0.548，95%CI：0.398～0.755，＜0.01）是保护因素，即接种疫苗可缩短核酸检测转阴时间。
结论
奥密克戎变异株感染的症状相对较轻且隐匿。年龄≥60 岁、合并高血压、未接种疫苗和 BMI＞24kg/cm 是核酸转阴时间延长的独立影响因素。
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