293例非重症型新型冠状病毒奥密克戎毒株感染患者感染特征及阳性持续时间分析

Analysis on infection characteristics and duration of positive testing in 293 cases of non-seevere COVID-19 infection caused by omicron variant

目的分析非重症型新型冠状病毒奥密克戎毒株感染患者的感染特征及阳性持续时间的影响因素。方法收集2022年7月1-23日宿州定点医院确诊的293例非重症型新型冠状病毒奥密克戎毒株感染者的诊断及治疗资料,并对患者进行问卷调查,对患者资料及问卷调查资料进行分析。采用Kaplan-Meier曲线及Log-rank检验或Breslow检验评价不同年龄、不同新型冠状病毒疫苗接种针数、不同中医证型及不同基础病数患者阳性持续时间的差异,采用多因素Cox风险回归分析核酸阳性持续时间的影响因素。结果293例新型冠状病毒奥密克戎毒株感染患者中,未发热115例(39.2%),发热178例(60.8%)。核酸阳性持续时间7~10 d的患者有98例。不同年龄、疫苗接种情况、基础病、中医证型、初期症状、发热患者的核酸阳性持续时间差异有统计学意义(F分别为4.941、7.560、15.703、11.738、11.025、19.597、11.470,P<0.05)。多因素Cox风险回归分析发现,年龄(HR=0.638,95%CI:0.464~0.878)、接种新型冠状病毒疫苗数(HR=1.416,95%CI:1.003~2.000;HR=1.955,95%CI=1.392~2.746)、基础病数(HR=0.659,95%CI:0.458~0.949;HR=0.553,95%CI=0.322~0.950;HR=0.299,95%CI:0.108~0.826)、中医证型(HR=0.583,95%CI:0.453~0.749)、初期症状(HR=0.416,95%CI:0.241~0.720)、是否发热(HR=0.954,95%CI:0.678~1.356)对阳性持续时间有影响(P<0.05)。热程对患者核酸阳性持续时间的影响(F=39.213,P<0.05),呈正向相关(r=0.559,P<0.05)。结论非重症型新型冠状病毒奥密克戎毒株感染患者中,≤20岁患者的核酸阳性持续时间较短,多种基础病会导致核酸阳性持续时间增加,接种2针及以上疫苗可以有效减少核酸阳性的持续时间,热程与患者核酸阳性持续时间有正向相关。

Objective To analyze the factors influencing infection characteristics and duration of positive testing in non-severe COVID-19 cases caused by the Omicron variant.Methods Diagnosis and treatment data of 293 confirmed cases of non-severe COVID-19 infection caused by the Omicron variant admitted to a designated hospital in Suzhou from July 1 to 23,2022 were collected.A questionnaire survey was conducted among the patients,and the collected data were analyzed.Kaplan-Meier curves and Log-rank or Breslow tests were used to evaluate the differences in the duration of positive testing among patients of different ages,with different numbers of vaccine doses,different traditional Chinese medicine(TCM)syndrome types,and different underlying diseases.Multivariate Cox regression analysis was conducted to explore the factors influencing the duration of positive testing.Results Among the 293 cases of COVID-19 infection caused by the Omicron variant,115 cases(39.2%)did not have a fever,while 178 cases(60.8%)had a fever.A total of 98 cases had a duration of positive testing ranging from 7 to 10 days.The differences in the duration of positive testing among patients of different ages,vaccination status,underlying diseases,TCM syndrome types,initial symptoms,and fever status were statistically significant(F=4.941,7.560,15.703,11.738,11.025,19.597,11.470,respectively,all P<0.05).Multivariate Cox regression analysis revealed that age(HR=0.638,95%CI:0.464-0.878),number of vaccine doses(HR=1.416,95%CI:1.003-2.000;HR=1.955,95%CI=1.392-2.746),underlying diseases(HR=0.659,95%CI:0.458-0.949;HR=0.553,95%CI=0.322-0.950;HR=0.299,95%CI:0.108-0.826),TCM syndrome type(HR=0.583,95%CI:0.453-0.749),initial symptoms(HR=0.416,95%CI:0.241-0.720),and fever status(HR=0.954,95%CI:0.678-1.356)had a significant impact on the duration of positive testing(P<0.05).The duration of fever had a positive correlation with the duration of positive testing(F=39.213,P<0.05;r=0.559,P<0.05).Conclusion In non-severe cases of COVID-19 infection caused by the Omicron variant,patients aged≤20 years had a shorter duration of positive testing,while various underlying diseases were associated with an increased duration of positive testing.Receiving two or more vaccine doses effectively reduced the duration of positive testing.The duration of fever was positively correlated with the duration of positive testing in patients.