Yuan Wenfang, Liu Yongmei, Zhan Haoting, Wei Feng, Zhang Qian, Gao Huixia, Yan Huimin, Huang Tao, Li Yongzhe, Dai Erhei
Division of Liver Diseases, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang, Hebei, China.
Department of Clinical Laboratory, State Key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
Front Med (Lausanne). 2024 Dec 18;11:1511227. doi: 10.3389/fmed.2024.1511227. eCollection 2024.
The aim of this study was to explore the clinical characteristics of patients infected with different Omicron subvariants presenting non-severe disease, evaluate the safety and efficacy of Azvudine for treatment of COVID-19, in order to broaden understanding of Omicron subvariant infections.
A total of 244 individuals with Omicron subvariant (BA.2.76, = 158; BA.5.1, = 86) were included in the study. Demographic, clinical, and laboratory data of the study participants were collected and analyzed.
Patients infected with BA.5.1 exhibited a higher incidence of clinical symptoms like fatigue (25.58% vs. 2.53%, < 0.001), headache/dizziness (12.79% vs. 4.43%, = 0.017), nausea/vomiting (10.47% vs. 1.27%, = 0.002), viral loads and inflammatory factors, and shorter virus shedding time than those with BA.2.76. There are 28.1% patients reporting mild adverse events following Azvudine administration. After treatment, the levels of anti-SARS-CoV-2 IgG/IgM, white blood cell, and lymphocyte obviously increased, while C-reactive protein, procalcitonin, and D-dimer reduced. Azvudine speeded up the time for virus clearance compared to control treatment (10 vs. 11 days, = 0.032). Low lymphocyte counts (odd ratio (OR) = 0.607, = 0.001) and anti-SARS-CoV-2 IgG titer (OR = 0.990, = 0.028) were the independent risk factors for long nucleic acid negativization duration after infection. Patients with pneumonia were often accompanied by dyspnea, fatigue and high level of D-dimer. Dyspnea (OR = 10.176, = 0.019) could be used to identify the occurrence of pneumonia in patients infected with Omicron.
The study demonstrated the difference in clinical and laboratory parameters between patients infected with Omicron BA.2.76 and BA.5.1, as well as the safety and efficacy of Azvudine therapy. Our study linked patient manifestations to Omicron subvariant, treatment, and clinical outcomes, which is conducive to healthcare providers/policymakers to revise and implement appropriate countermeasures, facilitating appropriately advise for individuals with Omicron subvariant infections.
本研究旨在探讨感染不同奥密克戎亚变体的非重症患者的临床特征，评估阿兹夫定治疗新型冠状病毒肺炎（COVID-19）的安全性和有效性，以加深对奥密克戎亚变体感染的认识。
本研究共纳入244例感染奥密克戎亚变体（BA.2.76，n = 158；BA.5.1，n = 86）的患者。收集并分析研究参与者的人口统计学、临床和实验室数据。
感染BA.5.1的患者出现疲劳（25.58% 对2.53%，P < 0.001）、头痛/头晕（12.79% 对4.43%，P = 0.017）、恶心/呕吐（10.47% 对1.27%，P = 0.002）等临床症状的发生率更高，病毒载量和炎症因子水平更高，病毒脱落时间比感染BA.2.76的患者更短。28.1%的患者在服用阿兹夫定后报告有轻度不良事件。治疗后，抗SARS-CoV-2 IgG/IgM、白细胞和淋巴细胞水平明显升高，而C反应蛋白、降钙素原和D-二聚体水平降低。与对照治疗相比，阿兹夫定加快了病毒清除时间（10天对11天，P = 0.032）。淋巴细胞计数低（比值比（OR）= 0.607，P = 0.001）和抗SARS-CoV-2 IgG滴度（OR = 0.990，P = 0.028）是感染后核酸转阴持续时间长的独立危险因素。肺炎患者常伴有呼吸困难、疲劳和高水平的D-二聚体。呼吸困难（OR = 10.176，P = 0.019）可用于识别感染奥密克戎的患者是否发生肺炎。
本研究证明了感染奥密克戎BA.2.76和BA.5.1的患者在临床和实验室参数上的差异，以及阿兹夫定治疗的安全性和有效性。我们的研究将患者表现与奥密克戎亚变体、治疗和临床结果联系起来，有助于医护人员/政策制定者修订和实施适当的应对措施，为感染奥密克戎亚变体的个体提供适当的建议。
