南京和扬州地区确诊新型冠状病毒肺炎患者临床特征分析

Analysis of clinical characteristics of confirmed COVID-19 patients in Nanjing and Yangzhou

目的探讨南京、扬州两个地区确诊的新型冠状病毒肺炎(COVID-19)患者感染早期的临床特征。方法本研究为横断面研究, 采用非随机抽样方法, 纳入2021年7月20日至8月17日南京市第二医院(汤山分院)收治的南京及扬州两地共545例COVID-19患者的资料, 均为德尔塔变异株感染。其中南京地区235例, 扬州地区310例。收集入院时的一般情况、疫苗接种情况、淋巴细胞计数、新型冠状病毒(SARS-CoV-2)核酸Ct值、胸部CT等资料, 并采用χ^(2)检验、独立样本t检验、秩和检验及logistics回归分析等对数据进行分析。结果扬州地区患者年龄明显高于南京地区[(51.96±21.64)岁比(42.98±17.82)岁, t=5.20, P<0.001], 扬州地区患有高血压[27.10%(84/310)比15.74%(37/235)]和冠状动脉粥样硬化性心脏病[3.55%(11/310)比0.85%(2/235)]的患者多于南京地区(χ^(2)值分别为9.97、4.18, P值均<0.05)。扬州地区临床分型中重型和危重型及CT病灶累及肺叶数多的患者多于南京地区, 鼻拭子SARS-CoV-2核酸Ct值高于南京地区(Z值分别为34.69、16.01、40.25, P值均<0.001):扬州地区患者完成全程新冠疫苗接种者少于南京地区(Z=31.99, P<0.001)。经logistics回归分析表明高龄和合并基础疾病是COVID-19患者发生重症的危险因素。结论扬州地区患者疫苗接种完成率偏低, 病情较重, 已接种新冠疫苗的人群对于德尔塔变异株具有一定的免疫, 高龄和患有基础疾病的患者易进展至重症。

Objective To investigate the early clinical characteristics of confirmed coronavirus disease 2019(COVID-19)patients in Nanjing and Yangzhou on admission.Methods By cross-sectional study,clinical data of 545 COVID-19 patients treated in The Second Hospital of Nanjing since July 20,2021,from Nanjing and Yangzhou were included,the general information,vaccination status for vaccines,blood lymphocyte count,novel coronavirus(SARS-CoV-2),RT-PCR threshold cycle(Ct)values for nucleic acid,chest computed tomography(CT)were collected,Chi-square test,independent-sample T test,rank sum test and logistics regression analysis were carried out for related data research and analysis.Results The higher age of patients from Yangzhou was common([51.96±21.64]years old vs[42.98±17.82]years old,t=5.20,P<0.001,respectivedy).Patients with hypertension(27.10%[84/310]vs 15.74%[37/235])and coronary heart disease(3.55%[11/310]vs 0.85%[2/235])in Yangzhou were more than those in Nanjing(χ^(2) were 9.97 and 4.18,all P<0.05).The number of patients with severe and critical,and with chest CT scan involving lung lobes from yangzhou were more than those from nanjing.Nucleic acid Ct value of SARS-CoV-2 in nasal swabs was higher in yangzhou than in patients in Nanjing(Z values were 34.69,16.01,40.25,respectively,all P<0.001).The number of patients completed whole-course vaccination was significantly less from yangzhou than from Nanjing(Z=31.99,P<0.001).Logistic regression analysis showed that risk factors for severe diseases of COVID-19 were old age and combined underlying diseases.Conclusions The rate of completed whole-course vaccination from yangzhou was lower with serious disease.Thus the population completed vaccines against COVID-19 is capable of producing immunity against Delta variant as analysis of clinical data of COVID-19 patients in two places,while older people and those with underlying diseases are more likely to develop severe disease.