上海方仓庇护医院 SARS-CoV-2 奥密克戎感染无症状和轻症患者的临床和病毒学特征。

Clinical and virological features of asymptomatic and mild symptomatic patients with SARS-CoV-2 Omicron infection at Shanghai Fangcang shelter hospital.

机构信息

Department of Internal Medicine, Central Medical Branch of Chinese PLA General Hospital, Beijing, People's Republic of China.

The Fourth Unit of Third Branch, Fangcang Shelter Hospital of National Exhibition and Convention Center, Shanghai, People's Republic of China.

出版信息

Immun Inflamm Dis. 2023 Sep;11(9):e1033. doi: 10.1002/iid3.1033.

Abstract

OBJECTIVE

The objective of this study is to evaluate and compare clinical and virological characteristics of asymptomatic and mild symptomatic patients of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron BA.2.2 variant infection and identify risk factors associated with the prolonged viral negative conversion duration.

METHODS

We conducted a retrospective observational study in a Shanghai (China) Fangcang shelter hospital from April 9 to May 17, 2022. The patient-related demographic or clinical data were retrospectively recorded. Comparisons of demographic and clinical characteristics between asymptomatic and mild-symptomatic patients were performed. Cox regression was performed to identify the risk factors of prolonged viral negative conversion duration.

RESULTS

A total of 551 patients confirmed with SARS-CoV-2 Omicron variant infection were enrolled in the study. Of these, 297 patients (53.9%) were asymptomatic and 254 patients (46.1%) had mild symptoms. When comparing the clinical and virological characteristics between the asymptomatic and mild symptomatic groups, several clinical parameters, including age, gender, time to viral clearance from the first positive swab, chronic comorbidities, and vaccination dose did not show statistically significant differences. In mild symptomatic patients, the median viral negative conversion duration (NCD) was 7 days (interquartile range [IQR]: 5-9), which was comparable to the median of 7 days (IQR: 5-10) in asymptomatic patients (p = .943). Multivariate Cox analysis revealed that patients age ≥ 60 years had a significantly higher hazard ratio (HR) for prolonged viral NCD (HR: 1.313; 95% confidence interval: 1.014-1.701, p = .039).

CONCLUSION

Asymptomatic and symptomatic patients with non-severe SARS-CoV-2 Omicron BA.2.2 variant infection have similar clinical features and virological courses. Old age was an independent risk factor for prolonged SARS-CoV-2 conversion time.

摘要

目的

本研究旨在评估和比较严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)奥密克戎 BA.2.2 变异感染的无症状和轻症患者的临床和病毒学特征,并确定与病毒转阴时间延长相关的危险因素。

方法

我们对 2022 年 4 月 9 日至 5 月 17 日期间在上海(中国)方仓庇护医院进行了一项回顾性观察性研究。回顾性记录了与患者相关的人口统计学或临床数据。比较了无症状和轻症患者的人口统计学和临床特征。采用 Cox 回归分析确定病毒转阴时间延长的危险因素。

结果

本研究共纳入 551 例确诊为 SARS-CoV-2 奥密克戎变异感染的患者。其中,297 例(53.9%)为无症状,254 例(46.1%)为轻症。比较无症状和轻症组的临床和病毒学特征时,年龄、性别、从首次阳性拭子到病毒清除的时间、慢性合并症和疫苗接种剂量等几个临床参数均无统计学差异。轻症患者的中位病毒转阴时间(NCD)为 7 天(IQR:5-9),与无症状患者的中位 NCD (7 天,IQR:5-10)相当(p = .943)。多因素 Cox 分析显示,年龄≥60 岁的患者病毒 NCD 延长的风险比(HR)显著更高(HR:1.313;95%置信区间:1.014-1.701,p = .039)。

结论

非重症 SARS-CoV-2 奥密克戎 BA.2.2 变异感染的无症状和轻症患者具有相似的临床特征和病毒学病程。年龄较大是 SARS-CoV-2 转换时间延长的独立危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1f8/10524057/4dc7dfd3e038/IID3-11-e1033-g003.jpg

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