2020年2—4月浙江省新型冠状病毒感染危险因素病例对照研究

Risk factors of COVID-19 infection in Zhejiang Province,China,February-April 2020:a case-control study

目的确认和定量评估浙江省新型冠状病毒感染的主要危险因素,为疫情防控提供参考依据。方法采用成组匹配的病例对照研究设计,选取2020年2—4月浙江省发病的新型冠状病毒感染者,以及等量的社区对照人群,收集人口学和暴露史等信息,采用logistic回归分析感染的影响因素。结果纳入病例组和对照组各327例,病例发病时间主要集中在2月(94.50%)。Logistic回归分析显示,新型冠状病毒感染者接触史[比值比(odds ratio,OR)=221.22,95%CI:99.18~493.43]、风险地区居住史(OR=39.08,95%CI:5.32~287.01)、风险地区旅行史(OR=28.12,95%CI:3.71~3603.05)、医疗机构暴露史(OR=17.09,95%CI:7.78~37.57)均为感染的危险因素。两组在职业分布上存在差异,感染与是否罹患基础性疾病差异无统计学意义(P>0.05)。结论与新型冠状病毒感染者接触是首要危险因素,风险地区旅居史、医疗机构暴露史也是重要的危险因素,防控重点是做好密切接触者追踪管理、开展风险地区流入人员筛查和减少风险地区或场所暴露。

Objective To identify and quantitatively assess the risk factors of coronavirus disease 2019(COVID-19)infection in Zhejiang Province,China,to provide a reference for epidemic prevention and control.Methods The onset dates from February to April 2020 of COVID-19 infections in Zhejiang Province were included and matched with an equal number of community controls.Demographic and exposure information was collected through a questionnaire,and logistic regression analysis was used to identify risk factors for infection.Results A total of 327 cases and the same number of controls were enrolled in the study.The onset dates of the cases were mainly(94.50%)in February 2020.Logistic regression analysis showed contact with COVID-19 infection(OR=221.22,95%CI:99.18-493.43),residence history in risk areas(OR=39.08,95%CI:5.32-287.01),travel history to high-risk areas(OR=28.12,95%CI:3.71-3603.05),and exposure to healthcare facilities(OR=17.09,95%CI:7.78-37.57)were risk factors for COVID-19 infection.There were differences across occupations in the case and control group,and there was no statistical association between infection and underlying conditions.Conclusions Contact with the COVID-19 case was the primary risk factor of infection in the pre-pandemic period;a history of traveling or living in risk areas and exposure to healthcare facilities also acted as important risk factors.The principle of prevention and control measures during that period should be on the management of close contacts,screening of individuals from high-risk areas,and reducing exposure to risk areas/places.