SARS-CoV-2感染者在不同流行时期临床特征的比较

A Comparative Study of Clinical Characteristics of SARS-CoV-2 Infected Patients in Different Epidemic Periods

目的比较SARS-CoV-2(severe acute respiratory syndrome coronavirus-2,SARS-CoV-2)病毒株在不同流行时期,引起COVID-19(corona virus disease 2019,COVID-19)后,发病早期患者的临床表现及实验室检测结果的差异,观察病毒流行不同阶段的致病性变化,为临床提供实验室依据,便于医生采取更加及时有效的治疗措施。方法收录了216例确诊新型冠状病毒感染的住院患者。通过两独立样本t检验,比较了2020年6月病例组(184例)和2021年1月病例组(32例)在基础病、并发症、实验室检测结果方面的差异,并通过图例更直观地展示有差异的指标在两组性别间的不同。结果在进行2020年6月病例组和2021年1月病例组的并发症的比较中,咽干咽痛(P=0.018)、恶心(P=0.039)、低钾血症(P<0.001)的P值均小于0.05;实验室检测数据的比较中,血气检测中的pH(P=0.009)、PCO_(2)(P<0.001)和HCT(P=0.011);血常规检测中,NE%(P=0.009)、LY%(P<0.001)、MO%(P=0.002);CKMB和LAC的P值均为P<0.001;血凝检测中的PT和APTT的P值分别为0.003和0.007;电解质检测中的K和Na的P值分别为<0.001和0.027。两组在以上比较中差异有统计学意义。结论2021年1月病毒株感染早期比2020年6月病毒株感染的患者并发症少,且实验室检测数据更趋于正常范围,说明病毒经过一段时间的传播,其引起的并发症有所下降,同时也说明传染性疾病的早发现,早管控,既减轻了患者的痛苦,又能节省医疗资源。

Objective To compare the clinical manifestations and laboratory results of SARS-CoV-2 virus strains across different epidemic periods after causing COVID-19 infection,and to observe pathogenic changes in different stages of the virus epidemic,so as to provide laboratory evidences for clinical practice.The study is aiming to facilitate timely and effective treatments.Methods 216 hospitalized patients with confirmed novel coronavirus infection were enrolled in this study.T test of two independent samples was used to evaluate the differences in basic diseases,complications and laboratory results between the June 2020 case group(184 patients)and the January 2021 case group(32 patients),and to illustrate the differences of different indicators between the two groups by using a graph.Results In the comparison of complications between the case group in June 2020 and the case group in January 2021,the P values of dry pharyngeal pain(P=0.018),nausea(P=0.039)and hypokalemia(P<0.001)were all less than 0.05.In the comparison of laboratory data,pH(P=0.009),PCO_(2)(P<0.001)and HCT(P=0.011)in blood gas detection;NE%(P=0.009),LY%(P<0.001),MO%(P=0.002),the P values of CKMB and LAC were all P<0.001.The P values of PT and APTT in hemagglutination were 0.003 and 0.007,respectively.P values of K and Na in electrolyte detection were less than 0.001 and 0.027,respectively.There were significant differences between the two groups in the above comparison.Conclusion In China,when comparing after January 2021 strains infection and June 2020 strains,there are fewer complications.The laboratory data tend to be within more normal range,suggesting the virulence declined.At the same time,it shows that early detection of infectious disease and early control can reduce patients’pain and save medical resources.