北京市新型冠状病毒轻型感染者的临床特征调查研究

Investigation and research on the clinical characteristics of patients with mild COVID-19 infection in Beijing

目的分析北京市新型冠状病毒(新冠肺炎病毒)轻型感染者的临床特征。方法以某公司员工及其家属为研究对象,采用横断面研究方法,以调查问卷的形式,调查分析新冠肺炎病毒轻型感染者的人口学数据、既往史、新冠肺炎感染后的临床症状及持续时间,以及咳嗽对生活质量的影响。结果调查结果显示,男性受试者为45.97%,平均年龄为(36.39±15.47)岁,10.17%的研究对象有基础病。新冠肺炎疫苗3针的接种率分别约为96.05%、93.28%、75.13%。98.27%的研究对象是首次感染,84.67%的感染者出现各种新冠肺炎相关症状。新冠肺炎感染后,发生率较高的症状依次为:发热(87.64%)、咳嗽(55.46%)、咽痛/咽干/咽痒(53.74%)、乏力(53.45%)、咳痰(52.59%)、头痛(42.82%)、全身酸痛/肌痛(37.93%)及鼻塞(32.76%)等。症状持续时间较长的有:咳嗽、嗅觉减退或消失、味觉减退或消失、睡眠困难、咳痰、呼吸困难/气紧/胸闷、乏力及咽痛/咽干/喉咙痒。发热的感染者,24.54%为低热,51.23%为中等热度、21.78%为高热,2.45%为超高热,高热组的用药率最高。发热和疼痛,在7 d内逐渐恢复基本正常;咳嗽以轻/中度咳嗽为主,恢复慢、持续时间较长;咳痰者以白痰居多,多数咳痰相对容易。咳嗽对新冠肺炎感染者短期及中长期生活质量,并未产生较大的影响。新冠肺炎感染者高发的精神神经症状有:乏力/疲劳、嗜睡、头晕、嗅觉/味觉下降、呼吸急促;持续时间较长的症状有:记忆力下降、恐惧/焦虑/紧张、冷空气过敏、思维障碍、失眠、乏力/疲劳、反应力差、味觉/嗅觉下降,以头部症状为主。多数人对新冠肺炎感染后的症状恢复及生活恢复充满信心。结论新冠首次感染后主要症状为发热、咳嗽、咽痛/咽干/咽痒、乏力、咳痰、头痛、全身酸痛/肌痛及鼻塞等,发热和疼痛恢复较快,咳嗽、味嗅觉减退/或消失、乏力、咽部不适及精神神经症状(头部症状为主)恢复缓慢,特别是乏力症状。提高营养食品的摄入、适度的身体锻炼、适当的工作量,都有助于感染者的症状恢复。

Objective To analyze the clinical characteristics of mild cases infected with novel coronavirus(COVID-19)in Beijing.Methods A cross-sectional study was conducted among employees and their family members of a company.A questionnaire was used to collect information on demographic data,past medical history,clinical symptoms and duration after COVID-19 infection,and the impact of cough on quality of life.Results The survey results showed that about 45.97%of the subjects were male,the average age was(36.39±15.47)years old,and 10.17%of the subjects had underlying diseases.The coverage rates of three doses of COVID-19 vaccine were 96.05%,93.28%and 75.13%,respectively.98.27%of the subjects were infected for the first time,and 84.67%of them showed various symptoms related to the COVID-19.After COVID-19 infection,the symptoms with high incidence were fever(87.64%),cough(55.46%),pharyngalgia/pharyngoxerosis/throat itching(53.74%),fatigue(53.45%),expectoration(52.59%),headache(42.82%),general soreness/myalgia(37.93%)and nasal congestion(32.76%).Symptoms with longer duration included cough,anosmia,ageusia,sleeping disorder,expectoration,dyspnea/polypnea/chest discomfort,fatigue and pharyngalgia/pharyngoxerosis/throat itching.Among the patients with fever,about 24.54%had low fever,51.23%had moderate fever,21.78%had high fever and 2.45%had extremely high fever,and the medication rate in the high fever group was the highest.Fever and pain gradually returned to almost normal within 7 days;Cough was mainly mild or moderate,which recovered slowly and lasted for a long time.The majority of patients with expectoration had white sputum,and most of them had relatively easy expectoration.Cough has no significant impact on the quality of life of patients with COVID-19 in the short-and long-term.The high incidence of mental and neurological symptoms in patients with COVID-19 include:fatigue,lethargy,dizziness,anosmia,ageusia,and polypnea;Symptoms with longer duration included memory impairment,fear/anxiety/nervousness,cold air allergy,cognitive impairment,insomnia,fatigue,poor responsiveness,anosmia,ageusia,which were mainly head symptoms.Most people were confident of symptom recovery and life recovery after COVID-19 infection.Conclusions The predominant symptoms of COVID-19 after the first infection were fever,cough,pharyngalgia/pharyngoxerosis/throat itching,fatigue,expectoration,headache,general soreness/myalgia and nasal obstruction.Fever and pain recovered quickly;cough,anosmia,ageusia,fatigue,pharyngeal discomfort and mental and neurological symptoms(mainly head symptoms)recover slowly.However,most infected people are confident that symptoms would recover.