接种灭活疫苗后的境外输入性新冠肺炎患者临床特征

Clinical characteristics of imported COVID -19 patients after inoculating inactivated vaccine

目的通过比较接种/未接种新型冠状病毒灭活疫苗(Vero细胞)后感染新型冠状病毒(COVID-19)的境外输入性患者的临床特征,为临床诊疗提供参考。方法选取2021年1月4日—4月10日广州医科大学附属市八医院收治的接种灭活疫苗后境外输入性COVID-19患者(接种疫苗组),及同期来自相同输入国家的未接种新冠疫苗的确诊COVID-19患者(未接种疫苗组)为研究对象,通过比较两组患者的人口学特征、临床症状、血液检查结果及抗体、胸部影像学、治疗方法及预后等,分析总结接种灭活疫苗后境外输入性COVID-19患者的临床特征。结果接种疫苗组、未接种疫苗组分别纳入38例患者,患者的平均年龄分别为(37.14±8.86)岁、(39.21±7.66)岁;男性58例,女性18例。两组患者的临床症状中,除了未接种疫苗组患者出现咽喉不适比率高于接种疫苗组(34.21%VS 13.16%,P<0.05),其余临床症状两组间比较,差异无统计学意义(P>0.05)。两组患者血白细胞、淋巴细胞、肝肾功能、心肌酶学、氧合指标、D-二聚体等指标比较,差异均无统计学意义(P>0.05);两组患者病程中出现炎症指标升高的比例、T淋巴细胞CD4^(+)、CD8^(+)下降的比例比较,差异均无统计学意义(P>0.05)。在病程前2周内,接种疫苗组患者新型冠状病毒抗体IgG阳性比例均高于未接种疫苗组,差异有统计学意义(P<0.05)。两组患者的肺部影像学情况比较,差异无统计学意义(P>0.05)。结论接种灭活新冠疫苗(Vero细胞)后境外输入性COVID-19患者以青中年男性为主,临床分型以核酸检测阳性及普通型患者居多,所有患者经治疗后均预后良好。接种灭活疫苗(Vero细胞)后再感染新型冠状病毒患者较未接种疫苗的患者,在病程早期(1周内)即迅速产生IgG抗体,但核酸转阴时间较长。

Objective To compare clinical characteristics of imported coronavirus disease 2019(COVID-19)patients after inoculated/non-inoculated inactivated vaccine(Vero cells)for SARS-CoV-2,provide reference for clinical diagnosis and treatment.Methods Imported COVID-19 patients who had inoculated inactivated vaccine(vaccinated group)and COVID-19 patients from the same countries but didn’t inoculate vaccine(non-vaccinated group)who were admitted in Guangzhou Eighth People’s Hospital,Guangzhou Medical University from January 4 to April 10,2021 were chosen.Through comparing the demographic characteristics,clinical symptoms,blood test results and antibodies,chest imaging,as well as treatment methods and prognosis of two groups of patients,clinical chara-cteristics of imported COVID-19 patients after inoculated inactivated vaccine were analyzed and summarized.Results 38 patients in vaccinated group and 38 in non-vaccinated group were included in analysis,the average age of patients was(37.14±8.86)and(39.21±7.66)years old respectively;58 were males and 18 were females.In the clinical symptoms of two groups,except throat discomfort rate of non-vaccinated group was higher than that of vaccinated group(34.21%vs 13.16%,P<0.05),there was no significant difference in other clinical symptoms between two groups(P>0.05).There were no significant differences in white blood cells,lymphocytes,liver and kidney function,myocardial enzyme,oxygenation index and D-2 polymer between two groups of patients(P>0.05);there were also no significant differences in the increased proportion of inflammation markers as well as decreased proportion of T lymphocytes CD4^(+)and CD8^(+)between two groups of patients(P>0.05).Within 2 weeks before disease course,positive rate of SARS-CoV-2 antibody IgG in vaccinated group was higher than that in non-vaccinated group,difference was statistically significant(P<0.05).There was no significant difference in lung imaging between two groups of patients(P>0.05).Conclusion Imported COVID-19 patients after inoculating inactivated vaccine(Vero cells)are mainly young and middle-aged men,most clinical types are nucleic acid test positive and common type,all patients had a good prognosis after treatment.Compared with patients without inoculating inactivated vaccine,patients infected SARS-CoV-2 after inoculating vaccine can produce IgG antibody rapidly in the early stage of disease(within one week),but nucleic acid turns negative for a long time.