The Third People's Hospital of Tibet Autonomous Region, Nongke Rd Chengguan District, Lhasa, Tibet, CN-850000, China.
Clinical Research Academy, Peking University Shenzhen Hospital, Futian District, Lianhua Road 1120Guangdong Province, Shenzhen, CN-518036, China.
BMC Infect Dis. 2024 Sep 2;24(1):907. doi: 10.1186/s12879-024-09831-x.
After a 920-day hiatus, COVID-19 resurged in the Tibet Autonomous Region of China in August 2022. This study compares the characteristics of COVID-19 between high-altitude residents and newcomers, as well as between newcomers and lowlanders.
This multi-center cohort study conducted at the Third People's Hospital of Tibet Autonomous Region and Beijing University Shenzhen Hospital, included 520 high-altitude resident patients, 53 high-altitude newcomer patients, and 265 lowlander patients infected with the Omicron variant. Initially, we documented epidemiological, clinical, and treatment data across varying residency at admission. We compared the severity of COVID-19 and various laboratory indicators, including hemoglobin concentration and SpO2%, over a 14-day period from the date of the first positive nucleic acid test, as well as the differences in treatment methods and disease outcomes between highlanders and high-altitude newcomers. We also compared several characteristics of COVID-19 between high-altitude newcomers and lowlanders. Univariate analysis, multivariable logistic regression, and the generalized linear mixed model were utilized for the analysis.
No fatalities were observed. The study found no significant differences in COVID-19 severity or in the physiological measures of hemoglobin concentration and SpO% between high-altitude and lowland residents. Similarly, there were no statistically significant differences in the values or trends of hemoglobin and SpO% between high-altitude residents and newcomers throughout the 14-day observation period. However, compared to age- and sex-matched lowlander patients (1:5 ratio), high-altitude newcomers exhibited higher heart rates, respiratory rates, and average hemoglobin concentrations, along with lower platelet counts. There were no significant differences in hospital stays between the two groups.
High-altitude residents and newcomer patients exhibit clinical similarities. However, the clinical characteristics of high-altitude newcomers and lowlander patients differ due to the impact of the high-altitude environment. These results highlight potential considerations for public health strategies in high-altitude regions such as Tibet.
2022 年 8 月，新冠疫情在中国西藏自治区时隔 920 天后再次爆发。本研究比较了高原居民与新移民、新移民与低海拔居民之间新冠病毒感染的特征。
本多中心队列研究在西藏自治区第三人民医院和北京大学深圳医院进行，共纳入 520 名高原居民患者、53 名高原新移民患者和 265 名感染奥密克戎变异株的低海拔居民患者。我们首先记录了入院时不同居住地的流行病学、临床和治疗数据。我们比较了从首次核酸检测阳性之日起 14 天内新冠病毒感染的严重程度和各种实验室指标（血红蛋白浓度和 SpO2%），以及高原居民和高原新移民之间治疗方法和疾病结局的差异。我们还比较了高原新移民和低海拔居民之间新冠病毒感染的几个特征。采用单因素分析、多变量逻辑回归和广义线性混合模型进行分析。
本研究未观察到死亡病例。研究发现，高原和低海拔居民之间新冠病毒感染的严重程度或血红蛋白浓度和 SpO%等生理指标无显著差异。同样，在 14 天的观察期内，高原居民和新移民之间血红蛋白和 SpO%的数值或趋势也没有统计学差异。然而，与年龄和性别匹配的低海拔居民患者（1:5 比例）相比，高原新移民的心率、呼吸频率和平均血红蛋白浓度较高，血小板计数较低。两组患者的住院时间无显著差异。
高原居民和新移民患者的临床特征相似。然而，由于高原环境的影响，高原新移民和低海拔居民患者的临床特征存在差异。这些结果强调了在西藏等高海拔地区制定公共卫生策略时需要考虑的潜在因素。
