方舱医院奥密克戎感染无症状及轻症病人核酸转阴时间的营养及其他相关因素分析

Analysis of nutrition and other factors on coronavirus nucleic acid negative transformation time in patients with asymptomatic and mild Omicron infections in mobile cabin hospital

目的:对上海国展中心方舱医院新型冠状病毒变异株“奥密克戎”感染病人进行营养评估,并初步分析影响病人核酸转阴天数的相关因素。方法:采用连续定点抽样方法,测量上海国展中心方舱医院新入病人的身高、体质量、体质量指数(BMI)、上臂围、腰围、小腿围、起坐时间,使用简易营养评定简表(MNA-SF)对病人进行营养风险筛查,并调研病人有无新冠相关症状、合并基础疾病以及疫苗接种情况,分析影响病毒RNA转阴时间的相关因素。结果:入组274例新冠病人,其中7 d内快速转阴、7~14 d转阴和大于14 d延迟转阴病人分别有67(24.45%)、137(50.00%)和70(25.55%)例。单因素结果分析表明,在三组不同转阴时间中,有无基础疾病是唯一表现出差异性(P=0.009)的指标。多因素Logistic分析表明,影响快速转阴(≤7 d)中变量,有基础疾病的新冠病人快速转阴的概率比没有基础疾病的病人降低约73%(OR=0.283,95%CI:0.093~0.706,P值=0.013);影响延迟转阴(≥14d)的多因素Logistic结果显示,有基础疾病的新冠病人延迟转阴的概率是没有基础疾病的病人的2.100倍(OR=2.100,95%CI:1.008~4.375,P值=0.047)。有无基础疾病是病人快速转阴(≤7d)或延迟转阴(≥14d)的唯一独立预测因素。在单因素及多因素分析中,营养相关变量包括体质量、BMI、上臂围、腰围、小腿围、起坐时间、MNA-SF评分等均与核酸转阴时间长短无相关性。结论:基础疾病是快速转阴和延迟不转阴的唯一独立预测因素。控制好基础疾病是减少重症发生的重要防治环节。营养风险筛查对于全面评估病人的机能状态、及早识别潜在高风险病人的意义值得重视。

Objectives:The aim of the study was to screen the nutritional risk of patients infected with novel coronavirus variant"Omicron"in the shelter Hospital of Shanghai International Exhibition Center,and initially analyze the relevant factors affecting how long it takes for their nucleic acid test results turn negative.Methods:Firstly,the continuous fixed-point sampling method was used to measure the height,weight,body mass index(BMI),arm girth,waistline,calf girth,and sit-up time of newly admitted patients in Shanghai International Exhibition Center shelter Hospital.Secondly,the risks of the patients’nutritional statuses were screened by Mini Nutritional Assessment—Short Form(MNA-SF),and the factors that affect the time of viral RNA negative conversion was analyzed.We also investigated their COVID-19-related symptoms,underlying diseases,and vaccination conditions.Results:Among the 274 patients infected with new coronavirus variant,67 patients(24.45%)turned negative within 7 days,137 patients(50.00%)turned negative within 7~14 days,and 70 patients(25.55%)took more than 14 days to turn negative;Univariate analysis showed that the presence or absence of underlying diseases was the only indicator that showed variability(P=0.009)among the three groups with different turnaround times.Multi-factor logistic analysis showed that the probability of rapid conversion was approximately 73%lower in patients with underlying disease than in patients without underlying disease(OR=0.283,95%CI:0.093~0.706,p-value=0.013)for variables affecting rapid conversion(≤7 d);The multivariate logistic analysis of delayed negative conversion(≥14d)showed that patients with underlying disease were 1.974 times more likely to have delayed conversion than those without underlying disease(OR=1.974,95%CI:0.991~3.894,p-value=0.050).The presence or absence of underlying disease was the only independent predictor of rapid(≤7 d)or delayed(≥14 d)patient conversion.In both univariate and multifactorial analyses,nutrition-related variables including body mass,BMI,arm girth,waistline,calf girth,sit-up time,and MNA-SF score were not correlated with the length of nucleic acid conversion.Conclusions:Underlying disease was the only independent predictor of rapid conversion and delayed non-conversion.Controlling the underlying disease is a pivotal part of prevention and treatment to reduce the occurrence of severe diseases.The significance of nutritional risk screening for comprehensive assessment of patients'functional status and early identification of potentially high-risk patients deserves attention.