新型冠状病毒肺炎疫情下呼吸道病原体变化趋势分析

An Analysis of the Dynamic Pattern of Respiratory Pathogens During the COVID-19 Outbreak

目的探讨新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)疫情前(2019年)、疫情期间(2020年)及疫情常态化(2021年)防控态势下7种常见呼吸道病原体感染的变化趋势,为临床诊疗和社区防控提供有效依据。方法采用RNA恒温扩增法检测2019年1月至2021年12月航空总医院就诊的上呼吸道感染者咽拭子标本7种呼吸道病原体(甲型流感病毒、乙型流感病毒、副流感病毒、呼吸道合胞病毒、腺病毒、肺炎支原体、肺炎衣原体)的核酸,分析呼吸道病原体的感染特征及变化趋势。结果新冠疫情前(2019年)、疫情期间(2020年)、疫情常态化(2021年)呼吸道病原体总体检出率分别为5.47%、2.56%、2.41%,呈现逐年下降趋势,差异有统计学意义(χ^(2)=366.388,P<0.05)。其中呼吸道合胞病毒检出率最高,分别为12.66%、7.95%、11.69%。按年龄段分析,0~14岁组每年的总体检出构成比率高于15~60岁组和>60岁组;疫情常态化防控下,15~60岁组乙型流感病毒检出率(60.37%)最高。按月份分析,除呼吸道合胞病毒每年的月检出率走势基本相同外,其余6种呼吸道病原体不同月份检出率呈现较大差异。结论新型冠状病毒肺炎疫情的严格防控措施有效遏制了呼吸道病原体的传播,改变了呼吸道病原体的分布结构,但具有明显季节性的呼吸道病原体仍具有较强的传播能力。

Objective To investigate the dynamic pattern of seven major respiratory pathogens before and after the COVID-19 outbreak,and to provide effective references for clinical diagnosis and treatment and community prevention.Methods Respiratory tract samples during 2019-2021 were collected and detected by isothermal amplification of RNA,and the detection rates of seven major respiratory pathogens(influenza A virus,influenza B virus,parainfluenza virus,respiratory syncytial virus,adenovirus,mycoplasma pneumoniae,chlamydia trachomatis)were analyzed.Results The overall detection rate of respiratory pathogens before COVID-19(2019),during the epidemic(2020),and epidemic normalization(2021)were 5.47%,2.56%,and 2.41%,respectively.It showed a downward trend yearly with the statistically significant difference among three years.The detection rate of RSV was the highest(12.66%,7.95%,11.69%).The overall rate of detection per year in the 0-14-year old group was higher than in the 15-60 and>60-year old groups.The detection rate of Flu B was the highest(60.37%)in patients aged 15-60 years.The annual monthly detection rate of RSV was generally the same trend and the other six respiratory pathogens were more different.Conclusion Adequate protective measures and isolation of COVID-19 have effectively contained the transmission of respiratory pathogens and changed the distribution structure of respiratory pathogens,but respiratory pathogens with obvious seasonal characteristics still have strong transmission capacity.