2020-2021年厦门输入性新型冠状病毒感染病例复阳情况分析

Analysis on"recurrence"RNA results of imported patients with novel coronavirus infection in Xiamen from 2020 to 2021

目的分析厦门输入性新型冠状病毒感染病例复阳情况。方法本研究为病例对照研究。采用非随机抽样的方法,收集厦门大学附属第一医院2020年3月1日至2021年7月1日收治的446例输入性新型冠状病毒感染患者病历资料。根据是否复阳分为复阳组113例和未复阳组333例。对比2组之间性别、年龄等一般情况、临床症状、实验室检查及治疗措施,并进一步使用logistic回归分析复阳危险因素。结果与未复阳组对比,复阳组患者合并基础疾病多,发热多,C反应蛋白、转氨酶高,淋巴细胞下降,使用氧疗及胸腺肽多,核酸转阴病程长,差异均有统计学意义(P值均<0.05);2组性别、年龄、体质量指数、疫苗接种、疾病严重程度、吸烟史、入院时病程、白细胞介素6、血清白蛋白、D二聚体、乳酸脱氢酶、入院时及出院时新型冠状病毒IgG和IgM、抗病毒、糖皮质激素使用等指标比较差异均无统计学意义(P值均>0.05)。多因素logistic回归分析中,发热、合并基础病及天冬氨酸转氨酶升高是复阳的危险因素,而中医中药是保护性因素(P值均<0.05)。结论患者伴发热,合并基础病,C反应蛋白、转氨酶升高,淋巴细胞下降,核酸转阴时间可能与复阳有关。其中发热、合并基础病及天冬氨酸转氨酶升高是复阳的危险因素,而中医中药是保护性因素。

Objective To analyze the clinical characteristics of"recurrence"RNA results of imported patients with novel coronavirus(nCoV)infection in Xiamen.Methods The study was determined to be a case-control study by non-random sampling method.The data of 446 imported cases with 2019-nCoV infection admitted to the First Affiliated Hospital of Xiamen University from March 1,2020 to July 1,2021 were collected and divided into the recurrence group(113 cases)and non-recurrence group(333 cases).The general conditions including the gender,age,etc,clinical symptoms,laboratory examinations and treatment measures of cases between two groups were compared,the risk factors for recurrence were further analyzed by multivariate logistic regression.Results Compared with the non-recurrence group,the patients in the recurrence group was found to have more cases of comorbidities and fever,higher C-reactive protein level,more cases with elevated transaminases and decreased lymphocytes,had more cases in need of oxygen therapy and treated with thymosin during hospitalization and longer duration of nucleic acid conversion,and the differences were statistically significant(all P<0.05),and differences of patients in the two groups in terms of the indexes including the age,gender,body mass index,vaccination,disease severity,smoking history,course of hospital admission,interleukin-6,serum albumin,D-dimer,lactate dehydrogenation and 2019-nCoV-IgG and IgM at both admission and discharge(all P>0.05)as well as antiviral,glucocorticoid use,etc during hospitalization were not statistically significant(all P>0.05).Multivariate logistic regression analysis showed that fever,comorbidities and elevated aspartate aminotransferase were risk factors for recurrence,while traditional Chinese medicine might be protective factor(all P<0.05).Conclusions The patients accompanied by fever combined with underlying diseases,elevated C-reactive protein and aspartate aminotransferase,decreased lymphocytes and prolonged negative conversion of nucleic acids are possibly related to the recurrence.The fever,comorbidities and elevated aspartate aminotransferase are considered to be risk factors for recurrence,while traditional Chinese medicine is protective factor.