基于类泊松回归的新冠感染病例发病影响因素分析

Analysis of factors influencing the incidence of SARS-CoV-2 infection cases based on quasi-Poisson regression

目的 分析和比较两种类型新型冠状病毒感染(简称新冠感染)病例的相关指标,确定新冠感染发病的主要影响因素,为疫情的防控提供借鉴和参考依据。方法 收集和汇总亚洲、欧洲、非洲共156个国家2020年1月22日—2022年3月27日的新冠感染日发病数、日疫苗接种数、日政府管控指数和人口发展指数等指标的数据,根据发病时间和特征将病例分类为以阿尔法、贝塔、德尔塔为主的毒株(第一类)和以奥密克戎为主(第二类)的毒株,借助广义线性模型的类泊松回归分析两类新冠感染发病与影响因素的关系,通过相对危险度RR值比较影响因素之间的差异。结果 筛选的149个国家中新冠感染发病率与人口发展指数(r=0.54)、中位数年龄(r=0.47)相关性较高,与平均管控指数相关性较低(r=0.18)。无论是第一类毒株还是第二类毒株,新冠感染发病的影响因素趋势基本一致,分析表明,疫苗接种是新冠感染发病的有效保护因素,两种类型病例的RR值分别为0.20和0.25,65岁以上人口比例是新冠感染发病的微弱危险因素,RR值为1.03和1.05,平均管控指数的RR值基本围绕在1.00附近,人口密度对发病影响无统计学差异。人口发展指数是发病的危险因素,两类病例的RR值分别为2.40和5.22。结论 疫苗接种是控制新冠感染病例的有效保护手段,65岁以上人口比例是发病的微弱危险因素,人口发展指数是发病的危险因素。对于后续以奥密克戎病例为主的疫情防控,疫苗覆盖率较低的国家和地区,首要的措施是继续提高疫苗接种覆盖率。

Objective To analyze and compare the indexes related to cases due to infection with two types of SARS-CoV-2 variants,to identify the main factors influencing the incidence of SARS-CoV-2 infection,and to provide references and a basis for prevention and control of the epidemic.Methods We collected and summarized the data regarding the number of daily incidence of SARS-CoV-2 infection,the number of vaccinations per day,daily government control index,and human development index(HDI) in 156 Asian,European,and African countries from January 22,2020 to March 27,2022.SARS-CoV-2 variants were divided into two types according to the onset time and characteristics of the cases,the first type mainly included Alpha,Beta and Delta variants of SARS-CoV-2,and the second one mainly included the Omicron variant.The general linear model with quasi-Poisson regression was used to analyze the relationship between the incidence of infection with two types of SARS-CoV-2 variants and its influencing factors,and the differences in the influencing factors were compared through the relative risk(RR) values.Results Among the 149 countries screened,the incidence rate of SARS-CoV-2 infection had a high correlation with HDI(r=0.54) and the median age(r=0.47),but a low correlation with the average government control index(r=0.18).The general trends of influencing factors were almost the same between the first and second types of variants.The analysis revealed that vaccination was an effective protective factor for preventing SARS-CoV-2 infection,and the RR values of two types of cases were 0.20 and 0.25 respectively.The proportion of population over 65 years old was a weak risk factor for SARS-CoV-2 infection,and the RR values were 1.03 and 1.05 respectively.The RR values for the government control index were generally around 1.00.There was no statistical difference in the effect of population density on the incidence.However,the analysis revealed that HDI was a risk factor for the incidence,with the RR values being 2.40 and 5.22 for both types of cases.Conclusion Vaccination is an effective protection approach to control the cases of SARS-CoV-2 infection.The proportion of the population over 65 years old is a weak risk factor for the incidence,and HDI is a risk factor for the incidence.For the prevention and control of subsequent epidemic mainly involving Omicron cases,the first measure is to continuously increase the coverage rate of vaccination in countries and regions with low vaccination coverage.