老年新型冠状病毒Omicron感染者核酸转阴的相关因素分析

Analysis of related factors of nucleic acid shedding in elderly patients infected with Omicron variant of SARS-CoV-2

目的分析新型冠状病毒(SARS-CoV-2)Omicron变异株在老年非重症感染者的转阴时间,并探讨影响病毒核酸转阴的相关因素。方法104例老年新型冠状病毒肺炎(以下简称新冠)非重症病人根据病毒核酸转阴时间被分为早期转阴组(<10 d)和晚期转阴组(≥10 d)。收集并比较2组病人人口学资料、疫苗接种、基础疾病、血常规、生化指标、炎症指标、每次病毒核酸检测ORF1ab基因和N基因Ct值,并对转阴时间的影响因素行相关性分析。结果新型冠状病毒Omicron变异株在老年非重症感染者的平均转阴时间为(10.21±3.51)d,早期转阴组平均转阴时间为(7.26±1.54)d,晚期转阴组平均转阴时间为(12.96±2.44)d。2组年龄,合并慢性心力衰竭、慢性肺病的比例,新冠疫苗加强接种比例,首次病毒核酸Ct值差异均具有统计学意义(P<0.05)。Spearman相关分析结果显示,Omicron变异株转阴时间与年龄、慢性心力衰竭、血清降钙素原水平呈正相关,与新冠疫苗加强接种,首次病毒核酸基因Ct值呈负相关。多元线性回归分析显示,年龄、新冠疫苗加强接种、首次病毒核酸Ct值是核酸转阴时间的独立影响因素。结论老年新冠Omicron非重症感染者核酸转阴时间差异大,影响因素多;年龄、新冠疫苗加强针接种、首次病毒核酸Ct值是核酸转阴的独立影响因素。对老年群体行疫苗加强针接种可缩短核酸转阴时间。

Objective To analyze the nucleic acid shedding time of Omicron variant of novel coronavirus in the elderly patients with non-severe infection,and to explore the related factors affecting the nucleic acid shedding time.Methods A total of 104 elderly patients with non-severe COVID-19 were divided into early negative group(<10 days)and late negative group(≥10 d)by the nucleic acid shedding time.The population information,vaccination,previous diseases,blood biochemical and inflammatory indicators,nucleic acid ORF1 ab gene and N gene Ct values were collected and compared between the two groups.The Spearman rank correlation and multiple linear regression were conducted to explore the influencing factors of the nucleic acid shedding time.Results The mean time of nucleic acid shedding of Omicron variant in the early negative group was 7.26±1.54 d,compared with 12.96±2.44 d in the late negative group.There were significant differences in age,the ratio of chronic heart failure,chronic pulmonary disease and booster vaccination for COVID-19 and the first nucleic acid Ct value between the two groups(P<0.05).Spearman correlation analysis showed that the nucleic acid shedding time of Omicron was positively correlated with age,chronic heart failure and serum level of procalcitonin,but negatively correlated with the vaccination booster and the first tested nucleic acid Ct value.Multiple linear regression analysis showed that age,vaccination booster and the first tested nucleic acid Ct value were the independent influencing factors of the nucleic acid shedding time.Conclusions Age,vaccination booster for COVID-19 and the first tested nucleic acid Ct value were the independent influencing factors of nucleic acid shedding in the elderly non-severe patients infected by SARS-CoV-2 Omicron.Vaccination booster for COVID-19 in the elderly vulnerable groups can shorten the time of nucleic acid shedding.