上海市228例新型冠状病毒奥密克戎变异株感染患者核酸转阴的影响因素

Influencing factors of negative conversion time of nucleic acid detection in 228 patients infected with Omicron variant of SARS-CoV-2 in Shanghai

目的比较不同临床特征对新型冠状病毒(SARS-CoV-2)奥密克戎(Omicron)变异株感染后核酸检测转阴时间的影响,为新型冠状病毒肺炎的隔离治疗提供科学依据。方法收集2022年4月27日—2022年6月8日上海市杨浦区五角场定点医院收治的228例上海市确诊SARS-CoV-2奥密克戎变异株感染的轻症患者流行病学和临床资料,以核酸转阴时间为结局变量,以核酸转阴时间(≤18 d)120例为A组和(>18 d)108例为B组。利用单因素及多因素logistic回归分析影响核酸转阴时间的因素。结果228例患者的平均核酸转阴时间为(18.7±12.1)d,中位时间18 d。其中A组平均核酸转阴时间为(13.2±2.0)d,B组为(20.8±1.3)d。单因素分析发现,高血压、冠心病、糖尿病、低钾血症、恶性肿瘤疾病对核酸转阴时间的影响差异无统计学意义(P>0.05);而合并有脑血管病、白细胞减少症、呼吸系统慢性疾病及疫苗接种对核酸转阴时间的影响差异有统计学意义(P<0.05)。进一步通过多因素Logistic回归分析发现,合并慢性呼吸系统疾病、未接种疫苗对核酸转阴时间延长有显著影响(P<0.05)。结论是否合并高血压、冠心病、糖尿病、低钾血症、恶性肿瘤、神经精神疾病、慢性消化系统疾病对核酸转阴时间无显著影响,而合并有慢性呼吸系统疾病以及未接种新冠疫苗与“奥密克戎”感染患者核酸转阴时间的延长显著相关。

Objective To analyze and compare the effects of different clinical characteristics on the negative conversion time of nucleic acid detection after severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)Omicron variant infection,and to provide a scientific basis for the isolation and treatment of coronavirus disease 2019(COVID-19).Methods The epidemiological and clinical data of 228 mild SARS-CoV-2 Omicron variant infected patients diagnosed in Shanghai were retrospectively collected from April 27,2022 to June 8,2022 in Wujiaochang designated Hospital,Yangpu District,Shanghai.The negative conversion time of nucleic acid detection was used as the outcome variable,and the patients were divided into A(≤18 days)and B(>18 days).Univariate and multivariate logistic regression analysis were used to analyze the influencing factors of the negative conversion time of nucleic acid detection.Results The mean nucleic acid conversion time of 228 patients was(18.7±12.1)d,with the median time of 18(2-46)d.Among them,120 patients in group A had an average nucleic acid conversion time of(13.2±2.0)d,and 108 cases in group B had an average nucleic acid conversion time of(20.8±1.3)d.Univariate analysis showed that there were no statistically significant differences in the effects of hypertension,coronary heart disease,diabetes,hypokalemia,malignant tumors,neuropsychiatric diseases,chronic digestive diseases on the negative nucleic acid conversion time(P>0.05);however,there were significant differences in the effects of combined cerebrovascular disease,leukopenia,chronic respiratory system diseases and vaccination on the negative nucleic acid conversion time(P<0.05).Further multivariate logistic regression analysis revealed that the combination of chronic respiratory diseases and non-vaccination were significant risk factors for prolongation of negative nucleic acid conversion time(P<0.05).Conclusions The results of this study show that gender,age and whether hypertension,coronary heart disease,diabetes mellitus,hypokalemia,malignant tumor,neuropsychiatric disease and chronic digestive disease have no significant effect on the nucleic acid conversion time,whereas chronic respiratory disease and no vaccination are significantly correlated with the prolongation of nucleic acid conversion time in SARS-CoV-2 Omicron-infected patients.