摘要
通过检索筛选到10项涉及2071例新型冠状病毒肺炎(COVID-19)患者出院后复查严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)核酸检测的研究,总结其流行病学、临床症状和辅助检查特征.COVID-19患者出院后病毒检测复阳病例占比为17.65%,而年龄较大的患者更有可能病毒复阳,临床症状合并咳嗽、咳痰、头晕症状的患者有SARS-CoV-2复阳的风险.此外,辅助检查结果呈双侧肺浸润且白细胞、血小板和CD4+T计数降低的患者有SARS-CoV-2病毒复阳的风险.这些因素可以被视为SARS-CoV-2复阳的预警指标,并可能有助于临床制定个体化管理策略.
Background:The proportion of recurrences after discharge among patients with coronavirus disease 2019(COVID-19)was reported to be between 9.1%and 31.0%.Little is known about this issue,however,so we performed a meta-analysis to summarize the demographical,clinical,and laboratorial characteristics of non-recurrence and recurrence groups.Methods:Comprehensive searches were conducted using eight electronic databases.Data re-garding the demographic,clinical,and laboratorial characteristics of both recurrence and non-recurrence groups were extracted,and quantitative and qualitative analyses were conducted.Results:Ten studies involving 2071 COVID-19 cases were included in this analysis.The proportion of recurrence cases involving patients with COVID-19 was 17.65%(between 12.38%and 25.16%)while older patients were more likely to experience recurrence(weighted mean difference(WMD)=1.67,range between 0.08 and 3.26).The time from discharge to recurrence was 13.38 d(between 12.08 and 14.69 d).Patients were categorized as having moderate severity(odds ratio(OR)=2.69,range between 1.30 and 5.58),while those with clinical symptoms including cough(OR=5.52,range between 3.18 and 9.60),sputum production(OR=5.10,range between 2.60 and 9.97),headache(OR=3.57,range between 1.36 and 9.35),and diz-ziness(OR=3.17,range between 1.12 and 8.96)were more likely to be associated with recurrence.Patients pre-senting with bilateral pulmonary infiltration and decreased leucocyte,platelet,and CD4+T counts were at risk of COVID-19 recurrence(OR=1.71,range between 1.07 and 2.75;WMD=?1.06,range between?1.55 and?0.57,WMD=?40.39,range between?80.20 and?0.48,and WMD=?55.26,range between?105.92 and?4.60,respectively).Conclusions:The main factors associated with the recurrence of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)after hospital discharge were older age,moderate severity,bilateral pulmonary infiltration,laboratory findings including decreased leucocytes,platelets,and CD4+T counts,and clinical symptoms including cough,sputum production,headache,and dizziness.These factors can be considered warning indicators for the recurrence of SARS-CoV-2 and might help the development of specific management strategies.
基金
Project supported by the National Science and Technology Major Project of China(Nos.2018ZX10302206 , 2017ZX10202203)
the Zhejiang University Academic Award for Outstanding Doctoral Candidates(No.2020052),China。
