Cao Yanmei, Zhang Jianping, Zhao Yiming, Hui Fen, Hu Zhijie, Shen Xinhua
Department of Occupational Medicine, The Affiliated Infectious Diseases Hospital of Soochow University, The Fifth People's Hospital of Suzhou, Suzhou, CHN.
Department of Tuberculosis Medicine, The Affiliated Infectious Diseases Hospital of Soochow University, The Fifth People's Hospital of Suzhou, Suzhou, CHN.
Cureus. 2023 Jun 30;15(6):e41200. doi: 10.7759/cureus.41200. eCollection 2023 Jun.
Background The Omicron variant of the coronavirus disease 2019 (COVID-19) virus has spread rapidly worldwide, even in areas with high vaccination rates. Consequently, it has further exacerbated the current global pandemic. In this study, we aimed to characterize the clinical severity of patients with the COVID-19 variant Omicron and analyze vaccine effectiveness in predicting clinical severity. Methodology A total of 142 patients who contracted the COVID-19 virus in the Omicron era were retrospectively studied, and differences in their clinical severity were analyzed. They were stratified as follows: unvaccinated vs. vaccinated, unvaccinated vs. one to two vaccine doses vs. three vaccine doses, and cycle threshold (CT) values ≤ 28 vs. CT > 28. Results Of the 142 patients, 27 were asymptomatic, 83 had mild disease, and 32 had moderate disease. The median age was 32 years for asymptomatic patients vs. 31 years for those with mild disease vs. 59 years for those with moderate disease (P＜0.05), and the direct medical hospitalization costs were ¥4901 for asymptomatic patients vs. ¥5259 for those with mild disease vs. ¥8378 for those with moderate disease (P＜0.05). Of the 142 patients, 112 (78.8%) were vaccinated, 11 (7.7%) had one vaccine dose, 63 (44.4%) had two vaccine doses, and 38 (26.7%) received three vaccine doses. The median direct medical cost in the vaccinated group was significantly lower than that in the unvaccinated group (¥5470.5 vs. ¥7535.5, P＜0.05). For ORF1ab and N genes, hospital stay length and direct medical cost significantly decreased in the group with CT values > 28 compared with those in the group with CT values ≤ 28 (P＜0.05). Multiple regression analysis showed that being ≥ 60 years old could be a predictor of moderate disease severity in patients, and three vaccine doses could be effective against moderate COVID-19. Conclusion Mild infection is the main clinical manifestation of the Omicron variant. Vaccination can significantly decrease direct Omicron-associated medical costs. Although vaccination cannot provide protection against severe disease caused by this variant, three vaccine doses are highly effective in preventing moderate COVID-19.
背景 2019 冠状病毒病（COVID-19）的奥密克戎变异株已在全球迅速传播，即使在疫苗接种率高的地区也是如此。因此，它进一步加剧了当前的全球大流行。在本研究中，我们旨在描述感染 COVID-19 奥密克戎变异株患者的临床严重程度，并分析疫苗有效性对预测临床严重程度的作用。方法 对奥密克戎流行时期感染 COVID-19 病毒的 142 例患者进行回顾性研究，分析其临床严重程度的差异。将患者分为以下几组：未接种疫苗组与接种疫苗组、未接种疫苗组与接种 1 - 2 剂疫苗组与接种 3 剂疫苗组、循环阈值（CT）值≤28 组与 CT＞28 组。结果 142 例患者中，27 例无症状，83 例为轻症，32 例为中症。无症状患者的中位年龄为 32 岁，轻症患者为 31 岁，中症患者为 59 岁（P＜0.05）；无症状患者的直接医疗住院费用为 4901 元，轻症患者为 5259 元，中症患者为 8378 元（P＜0.05）。142 例患者中，112 例（78.8%）接种了疫苗，11 例（7.7%）接种 1 剂疫苗，63 例（44.4%）接种 2 剂疫苗，38 例（26.7%）接种 3 剂疫苗。接种疫苗组的中位直接医疗费用显著低于未接种疫苗组（5470.5 元 vs. 7535.5 元，P＜0.05）。对于 ORF1ab 和 N 基因，CT 值＞28 组的住院时间和直接医疗费用与 CT 值≤28 组相比显著降低（P＜0.05）。多元回归分析表明，年龄≥60 岁可能是患者中症严重程度的一个预测因素，接种 3 剂疫苗对预防 COVID-19 中症有效。结论 轻症感染是奥密克戎变异株的主要临床表现。接种疫苗可显著降低与奥密克戎相关的直接医疗费用。虽然接种疫苗不能预防该变异株引起的重症，但接种 3 剂疫苗对预防 COVID-19 中症非常有效。
