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感染新冠病毒奥密克戎变异株的住院老年患者进展为严重感染及病毒清除时间延长的危险因素:同济大学医学院附属上海市第四人民医院的一项回顾性研究

Risk factors for progression to severe infection and prolonged viral clearance time in hospitalized elderly patients infected with the Omicron variant of SARS-CoV-2: a retrospective study at Shanghai Fourth People's Hospital, School of Medicine, Tongji University.

作者信息

Tang Siqi, Man Qiuhong, Zhu Dongliang, Yu Xueying, Chen Ruilin, Wang Shuo, Lu Yihan, Shi Qiqing, Suo Chen, Xiong Lize

机构信息

Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China.

Department of Epidemiology, Ministry of Education, Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China.

出版信息

Front Microbiol. 2024 Apr 15;15:1361197. doi: 10.3389/fmicb.2024.1361197. eCollection 2024.

Abstract

INTRODUCTION

In elderly patients infected with the Omicron variant, disease progression to severe infection can result in poor outcomes. This study aimed to identify risk and protective factors associated with disease progression to severe infection and viral clearance time in elderly Omicron-infected patients.

METHODS

Shanghai Fourth People's Hospital, School of Medicine, Tongji University, was officially designated to provide treatment to patients with COVID-19. This study was conducted on confirmed Omicron cases admitted to the hospital between 10 April 2022 and 21 June 2022. In total, 1,568 patients aged 65 years or older were included. We conducted a retrospective, observational study using logistic regression to analyze risk and protective factors for the development of severe disease and Cox proportional hazards regression models to analyze factors influencing viral clearance time.

RESULTS

Aged over 80 years, having 2 or more comorbidities, combined cerebrovascular disease, chronic neurological disease, and mental disorders were associated with the development of severe disease, and full vaccination was a protective factor. Furthermore, aged over 80 years, combined chronic respiratory disease, chronic renal disease, cerebrovascular disease, mental disorders, and high viral load were associated with prolonged viral clearance time, and full vaccination was a protective factor.

DISCUSSION

This study analyzed risk factors for progression to severe infection and prolonged viral clearance time in hospitalized elderly Omicron-infected patients. Aged patients with comorbidities had a higher risk of developing severe infection and had longer viral clearance, while vaccination protected them against the Omicron infection.

摘要

引言

在感染奥密克戎变异株的老年患者中,疾病进展为严重感染可能导致不良后果。本研究旨在确定与老年奥密克戎感染患者疾病进展为严重感染及病毒清除时间相关的风险因素和保护因素。

方法

同济大学医学院附属上海市第四人民医院被正式指定为新冠肺炎患者提供治疗。本研究对2022年4月10日至2022年6月21日期间收治的确诊奥密克戎病例进行。共纳入1568例65岁及以上的患者。我们进行了一项回顾性观察研究,使用逻辑回归分析重症疾病发生的风险因素和保护因素,并使用Cox比例风险回归模型分析影响病毒清除时间的因素。

结果

年龄超过80岁、患有2种或更多种合并症、合并脑血管疾病、慢性神经系统疾病和精神障碍与重症疾病的发生相关,而全程接种疫苗是一个保护因素。此外,年龄超过80岁、合并慢性呼吸系统疾病、慢性肾脏疾病、脑血管疾病、精神障碍和高病毒载量与病毒清除时间延长相关,而全程接种疫苗是一个保护因素。

讨论

本研究分析了住院老年奥密克戎感染患者进展为严重感染和病毒清除时间延长的风险因素。患有合并症的老年患者发生严重感染的风险较高,病毒清除时间较长,而接种疫苗可保护他们免受奥密克戎感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/95c8/11056568/4dfbe48937ff/fmicb-15-1361197-g0001.jpg

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