苏州市新型冠状病毒奥密克戎变异株本土感染者的临床特征分析

Clinical features of local infected patients with Omicron variant of SARS-CoV-2 in Suzhou

目的了解新型冠状病毒奥密克戎(Omicron)变异株本土感染者的临床特征,为疫情防控提供参考。方法回顾性分析2022年2月13日至3月2日于苏州大学附属传染病医院确诊的143例新型冠状病毒Omicron变异株本土感染者的临床资料、实验室检查、临床分型、治疗及预后,比较无症状(29例)及轻型患者(84例)与普通型患者(30例)之间、各疫苗接种针数及各年龄组患者之间核酸转阴时间及新冠抗体IgG值的差异。结果与无症状及轻型组患者相比,普通型组患者年龄偏大,为(52.53±21.63)岁(t=-4.67,P<0.001),合并高血压、慢性支气管炎及脑梗塞比率高(χ2=25.93,P<0.001;χ2=10.89,P=0.001;χ2=3.86,P=0.049),接种疫苗比率低(χ2=4.75,P=0.029),IL-6值较高(Z=-3.71,P<0.001),抗体IgG值较低(Z=2.23,P=0.026),咳痰及乏力症状比率较高(χ2=4.72,P=0.030;χ2=3.98,P=0.046),症状好转时间及核酸转阴时间均较长(t=2.10,P=0.038;t=2.32,P=0.022)。与未接种或接种1针及2针组患者相比,接种3针疫苗组患者抗体IgG值更高(Z=-6.78,P<0.001;Z=-3.07,P=0.013;Z=-3.78,P=0.001)。与老年组患者相比,儿童及青壮年组患者核酸转阴时间较短,儿童组患者抗体IgG值较高(t=-4.80,P=0.002;t=-2.78,P=0.016;Z=3.21,P=0.008)。结论本土感染的Omicron变异株感染者总体临床症状较轻,预后较好。老年患者,有基础疾病及未接种疫苗患者易出现咳痰及乏力症状,发生肺炎的风险增高,病程延长。接种加强针疫苗,能产生更高的IgG抗体,增强免疫力。

Objective To understand the clinical characteristics of local infected patiens with Omicron variant of SARS-CoV-2,so as to provide references for epidemic prevention and control.Methods The clinical data,laboratory tests,clinical classification,treatment and prognosis of 143 patients with local infection of Omicron variant of SARS-CoV-2 in Soochow University Affiliated Hospital for Infectious Disease from February 13 to March 2,2022 were retrospectively analyzed.The differences in nucleic acid conversion time and IgG of COVID-19 antibody between asymptomatic and mild patients(29 cases and 84 cases)and ordinary patients(30 cases),among patients with the different doses of vaccine injection,and with the different ages were compared.Results Compared with the asymptomatic and mild group,the patients in the ordinary group were older with the age of(52.53±21.63)years old(t=-4.67,P<0.001),and had the higher rates of hypertension,chronic bronchitis and cerebral infarction(χ2=25.93,P<0.001;χ2=10.89,P=0.001;χ2=3.86,P=0.049),the lower rate of vaccination(χ2=4.75,P=0.029),the higher level of IL-6(Z=-3.71,P<0.001),the lower IgG level(Z=2.23,P=0.026),the higher rates of sputum and fatigue symptoms(χ2=4.72,P=0.030;χ2=3.98,P=0.046),the longer time for symptom improvement and nucleic acid to turn negative(t=2.10,P=0.038;t=2.32,P=0.022).Compared with the unvaccinated or 1-and 2-dose vaccination groups,patients in 3-dose vaccination group had higher IgG level(Z=-6.78,P<0.001;Z=-3.07,P=0.013;Z=-3.78,P=0.001);Compared with the elderly group,the nucleic acid conversion time in the children and young adults were shorter,and IgG level in children was higher(t=-4.80,P=0.002;t=-2.78,P=0.016;Z=3.21,P=0.008).Conclusions The overall clinical symptoms of patients infected with Omicron variant are mild and the prognosis is good.Elderly patients,patients with underlying diseases and without vaccination are prone to sputum and fatigue symptoms,increase the risk of pneumonia,and prolong the course of the disease.Booster vaccination can produce higher IgG antibodies and enhance immunity.