成都市290例境外输入性新型冠状病毒感染者临床特征分析

Clinical characteristics of 290 foreign-imported cases infected with SARS-CoV-2 in Chengdu, China

目的:分析成都市境外输入性新型冠状病毒(SARS-CoV-2)感染者的流行病学及临床特征。方法:纳入在成都市公共卫生临床医疗中心治愈出院的290例境外输入性SARS-CoV-2感染者,分为无症状感染者组(131例)及确诊病例组(159例),比较两组患者的流行病学特征、临床特征及实验室检查结果,通过多因素logistic回归分析探讨感染SARS-CoV-2后成为确诊病例的影响因素。结果:290例患者年龄2个月~68岁,14~49岁年龄段人数最多(247例),男性占比83.4%,62.1%来自亚洲,43.8%合并脂肪肝。确诊病例组以普通型患者为主(80.5%),仅1例重型患者。无症状感染者组住院时间短于确诊病例组,两组复诊时(出院后半个月)的淋巴细胞计数、CD4^(+)T计数、CD8^(+)T计数、CD4^(+)T/CD8^(+)T、肌酸激酶均较入院时降低,丙氨酸转氨酶、天冬氨酸转氨酶、白蛋白、乳酸脱氢酶、肌酸激酶同工酶均较入院时升高(P<0.05)。logistic回归分析显示年龄增长、入院时淋巴细胞计数减少、入院时乳酸脱氢酶增加与显性感染相关。有13例普通型患者复诊时的肺部病灶较出院时增加,其中3例核酸"复阳"。结论:成都市境外输入病例主要来源于亚洲,重症患者少。部分SARS-CoV-2感染者在康复早期仍存在病毒间断复制。对境外输入患者早隔离、早治疗不仅有利于疫情防控,还可能改变了自然病程。

Objective:To analyze the epidemiological and clinical characteristics of foreign-imported patients infected with SARS-CoV-2 in Chengdu City.Methods:A total of 290 foreign-imported patients infected with SARS-CoV-2 and discharged from Public Health Clinical Center of Chengdu were included in our study,and they were divided into asymptomatic infection group(131 cases)and confirmed cases group(159 cases)in order to compare the epidemiology,clinical characteristics and laboratory tests between two groups.Multi-factor logistic regression analysis was used to investigate the influence factors of becoming a dominant infection after infected with SARS-CoV-2.Results:Among the 290 cases aged from 2 months to 68 years old,83.4%were males,62.1%came from Asia,and 43.8%were complicated with fatty liver disease,the age group of 14-49 years old had the largest number(247 cases).Together 80.5%confirmed case group cases were general type,and there was only 1 severe patient.Hospital stays in asymptomatic infection group was shorter than that in confirmed cases group,lymphocyte count,CD4^(+)T count,CD8^(+)T count,CD4^(+)T/CD8^(+)T creatine kinase in two groups half a month after discharge were relatively lower than those on admission,and alanine aminotransferase,aspartate aminotransferase,albumin,lactate dehydrogenase,creatine kinase isoenzyme were relatively higher than those on admission(P<0.05).Logistic regression analysis showed that increased age,decreased lymphocyte count on admission and increased lactate dehydrogenase on admission were associated with dominant infection.Chest CT of 13 general type cases indicated an increase in lesions compared with that at discharge and 3 of them had re-detectable positive RNA test.Conclusion:The majority of foreign-imported cases in Chengdu were mainly from Asia,of which fewer were severe patients.In the early stage of recovery,some SARS-CoV-2 infected patients still had intermittent viral replication.Early isolation and early treatment of imported patients was not only conducive to epidemic prevention and control,but also might change the natural course of the disease.