益生菌制剂对方舱医院新型冠状病毒感染轻型患者的临床应用

Clinical application of probiotics in patients with mild COVID-19 in a Fangcang shelter hospital

目的观察益生菌对奥密克戎变异株新型冠状病毒感染(COVID-19)轻型患者病程的影响。方法回顾性分析2022年5月2日至12日上海国家会展中心方舱医院三分院病区收治的133例COVID-19轻型患者病历资料,根据是否接受了益生菌(枯草杆菌二联活菌肠溶胶囊)辅助治疗,在成年(18~59岁)和老年(≥60岁)两个年龄段分别设对照组和益生菌组,成年段共79例,其中对照组40例,益生菌组39例;老年段共54例,其中对照组28例,益生菌组26例。比较对照组和益生菌组新型冠状病毒感染核酸转阴时间、住院天数、ORFlab基因和N基因清除速率以及主要症缓解情况。采用SPSS 26.0软件统计分析。根据数据类型采用t检验、Wilcoxon秩和检验,χ2检验或Fisher确切概率法检验。结果成年段对照组和益生菌组间核酸转阴时间、住院天数、ORFlab基因及N基因清除速率、主要症状缓解情况的差异均无统计学意义;老年段对照组和益生菌组核酸转阴时间[11.0(9.0,13.0)和8.0(6.0,10.0)d]、住院天数[10.5(9.0,13.0)和8.0(6.0,10.0)d]的差异有统计学意义(P<0.05),ORFlab基因及N基因清除速率、主要症状缓解情况的差异无统计学意义。核酸转阴Kaplan-Meier曲线显示,成年段对照组和益生菌组中位转阴时间(7.0和6.0 d),差异无统计学意义;老年段对照组和益生菌组中位转阴时间(11.0和8.0 d),差异有统计学意义(P=0.001)。结论益生菌辅助治疗可以促进老年奥密克戎变异株COVID-19轻型患者核酸转阴。

Objective To observe the effects of probiotics on the course of mild coronavirus disease 2019(COVID-19)caused by Omicron variant.Methods A retrospective analysis was performed of the medical data of 133 COVID-19 patients admitted to the third ward of Fangcang shelter hospital located in the National Exhibition and Convention Center(Shanghai)from May 2 to May 12,2022.The patients were divided into two age cohorts:adult(18-59 years old,n=79)and elderly(≥60 years old,n=54).Each cohort was further divided into control group and probiotics group according to whether they received the adjuvant treatment of probiotics(subtilis bifunctional enteric-coated capsule).Of the adult cohort,40 patients were in the control group and 39 in the probiotics group;of the elderly cohort,28 were in the control group and 26 in the probiotics group.The two groups in both age cohorts were compared in negative conversion time of the SARS-CoV-2 nucleic acid,length of hospital stay,clearance rates of ORFlab gene and N gene,and relief of main symptoms.SPSS 26.0 was used for statistical analysis.According to the data type,t-test,Wilcoxon rank sum test,χ2 test,or Fisher exact probability method was used for inter-group comparison.Results In the adult cohort,there was no statistically significant difference in negative conversion time of the nucleic acid,length of hospital stay,ORFlab gene clearance rate,N gene clearance rate,and relief of main symptoms between the control group and the probiotics group.In the elderly cohort,there were statistically significant differences between the two groups in negative conversion time of the nucleic acid[11.0(9.0,13.0)vs 8.0(6.0,10.0)d]and the length of hospital stay[10.5(9.0,13.0)vs 8.0(6.0,10.0)d](P<0.05 for both),but there was no statistically significant difference in the clearance rate of ORFlab gene and N gene.The Kaplan-Meier curves showed that there was no statistically significant difference in the median conversion time between the two groups in the adult cohort(7.0 vs 6.0 d;P=0.383),and that there was a statistically significant difference in the elderly cohort(11.0 vs 8.0 d).Conclusion The adjuvant treatment of probiotics can enhance negative conversion of the nucleic acid in the elderly patients with mild COVID-19 caused by Omicron variant.