辽宁省新型冠状病毒肺炎病例密切接触者感染风险及其影响因素分析

Infection risk and its influencing factors among close contacts of patients with novel coronavirus disease 2019 in Liaoning province

目的通过分析辽宁省新型冠状病毒肺炎病例密切接触者感染风险的影响因素,为寻找感染防控重点人群、制定精准防控策略提供科学依据。方法利用辽宁省2020年1月22日至2月29日报告的新型冠状病毒肺炎病例密切接触者数据、病毒检测结果,分析密切接触者不同特征人群中感染风险的差异。结果 2 784例密切接触者中有67例感染(2.41%)。单因素分析结果显示:与16~45岁的密切接触者相比,≤15岁、46~60岁、61~75岁、> 75岁的密切接触者有较大的感染风险;与指示病例关系为亲属、共同居住生活的密切接触者有较大的感染风险。多因素分析结果显示:剔除有外省旅居史的感染者后,与非亲属关系密切接触者相比,其他亲属(OR=4.845,95%CI=1.350~17.393)、直系亲属(OR=27.571,95%CI=6.361~119.501)、夫妻(OR=26.200,95%CI=4.702~146.000)关系的密切接触者感染风险显著升高。密切接触者感染严重程度与年龄(r=0.445,P <0.001)、指示病例的临床严重程度(r=0.243,P=0.048)呈正相关。结论新型冠状病毒肺炎病例密切接触者感染风险与年龄、与指示病例的关系、接触方式相关,而感染严重程度与年龄、指示病例的临床严重程度呈正相关。新型冠状病毒传播途径主要是近距离密切接触传播,且存在显著的家庭聚集性。

Objective To analyze infection risk and its influencing factors among close contacts of patients with novel coronavirus disease 2019(COVID-19) in Liaoning province for providing evidences to develop precise prevention and control strategies. Methods We collected the information on all close contacts of COVID-19 cases reported in Liaoning province from January 22 to February 29, 2020. Unconditional logistic regression analysis was adopted to explore disparities in the infection risk among different close contacts. Results Of the 2 784 close contacts identified, 67(2.41%) infections were confirmed by virus nucleic acid test. Univariate analysis results demonstrated that compared with those aged 16-45 years, the close contacts of other age groups were more likely to be infected;the close contacts being an index case′ relative or cohabitating with an index case had a higher infection risk. After excluding 25 close contacts with a history of traveling in other provinces, the results of multivariate analysis revealed that in comparison with those having no family relationship with the index case, the close contacts being the index cases′ distant relatives(odds ratio [OR] = 4.845, 95% confidence interval[95% CI]: 1.350-17.393), immediate relatives(OR = 27.571, 95% CI: 6.361-119.501), and spouses(OR = 26.200,95% CI: 4.702-146.000) were at a significantly increased infection risk. The disease severity of the infected close contacts was positively correlated with age(r = 0.445, P < 0.001) and disease severity of the index case(r = 0.243, P = 0.048).Conclusion The infection risk of close contacts of patients with COVID-19 is related to age, the relationship and the mode of contact with the index case. The disease severity of an infected close contact is related to the contact′s age and the disease severity of the index case. Close contact is a main route for COVID-19 transmission and family clustering is prevalent in COVID-19 epidemic.