Chongqing Medical University, Chongqing, China.
Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
BMJ Open Respir Res. 2023 Aug;10(1). doi: 10.1136/bmjresp-2023-001729.
Pneumonia is the main complication of the Omicron variant of SARS-CoV-2; however, the incidence proportions and prognostic factors for Omicron-associated pneumonia have not been established. We conducted this study to characterise the incidence proportions and influence of various factors on prognosis of Omicron-associated pneumonia.
We collected data from 714 patients infected with the Omicron variant in The First Affiliated Hospital of Chongqing Medical University (Chongqing, China) who were divided into different groups for analysis.
We identified 313 patients with Omicron-associated pneumonia at the time of diagnosis of patients infected with the Omicron variant, representing 43.8% of the entire cohort. A total of 82 were 15-59 years old, 71 were 60-69 years old, 76 were 70-79 years old and 84 were >80 years old. 133 were female and 180 were male. Incidence proportions of pneumonia were highest among patients with cardiovascular (82.4% of the basic disease of the cardiovascular system subset) or kidney disease (92.3% of the kidney disease subset), whereas patients with lung cancer (35.7% of the lung cancer subset) had a lower incidence proportion. Several factors were associated with the prognosis of pneumonia in patients infected with the Omicron variant. Patients with a thrombosis or pleural effusion had a longer hospitalisation time. Paxlovid and immunoglobulins improved the prognosis of patients with severe pneumonia. The following measures were significantly different in patients as a function of disease severity: number of neutrophils and lymphocytes, partial oxygen pressure; and myoglobin, lactic dehydrogenase, aspartate transaminase and procalcitonin levels.
Patients infected with the Omicron variant with coexisting cardiovascular or kidney disease, but not respiratory disease, had a higher incidence proportion of pneumonia. Paxlovid and immunoglobulins can be used in patients with severe infections to improve prognosis.
肺炎是 SARS-CoV-2 奥密克戎变异株的主要并发症;然而,奥密克戎相关肺炎的发病比例和预后因素尚未确定。我们进行这项研究是为了描述奥密克戎相关肺炎的发病比例和各种因素对预后的影响。
我们收集了重庆医科大学附属第一医院(中国重庆)714 例感染奥密克戎变异株患者的数据,并将其分为不同的组进行分析。
我们在感染奥密克戎变异株的患者中发现了 313 例奥密克戎相关肺炎患者,占整个队列的 43.8%。其中 82 例年龄为 15-59 岁,71 例年龄为 60-69 岁,76 例年龄为 70-79 岁,84 例年龄>80 岁。133 例为女性,180 例为男性。在心血管疾病(心血管疾病亚组基础疾病的 82.4%)或肾脏疾病(肾脏疾病亚组的 92.3%)患者中,肺炎的发病比例最高,而在肺癌(肺癌亚组的 35.7%)患者中,肺炎的发病比例较低。一些因素与感染奥密克戎变异株患者肺炎的预后相关。有血栓或胸腔积液的患者住院时间更长。帕罗维德和免疫球蛋白改善了重症肺炎患者的预后。根据疾病严重程度,患者的以下措施存在显著差异:中性粒细胞和淋巴细胞计数、部分氧分压;以及肌红蛋白、乳酸脱氢酶、天门冬氨酸转氨酶和降钙素原水平。
患有共存心血管或肾脏疾病但无呼吸系统疾病的奥密克戎变异株感染者,肺炎的发病率较高。在严重感染患者中使用帕罗维德和免疫球蛋白可以改善预后。