新型冠状病毒重复感染临床特点与风险分析

Clinical characteristics and risk analysis of novel coronavirus repeated infection

目的了解新型冠状病毒重复感染的临床特点,探究新型冠状病毒重复感染的危险因素。方法纳入2022年12月至2023年1月于首都医科大学附属北京中医医院发热门诊收治的340例新型冠状病毒感染患者的临床数据,比较非重复感染组和重复感染组以及重复感染组中首次及二次感染的一般特征、基础疾病、临床症状、检查结果。采用二元logistic多因素分析探究新型冠状病毒再次感染的危险因素。结果本研究纳入340例新型冠状病毒感染患者,其中180例为重复感染。重复感染组与非重复感染组患者性别、年龄、BMI、运动、吸烟、作息及基础病方面,差异无统计学意义(均P>0.05),但重复感染组患者疫苗接种率较非重复感染组低[80.0%(144/180)vs 88.0%(142/160),P<0.05];重复感染组中157例(87.2%)伴有周身不适(包括头痛、乏力、肌肉关节痛),较非重复感染组122例(76.2%)明显增多,首次感染时发生肺炎比例[15.6%(28/180)]较非重复感染组[7.5%(12/160)]高,差异有统计学意义(P<0.05)。重复感染组首次与再次感染间隔(166.2±8.3)d。咳嗽咯痰是两次感染的主要临床表现;再次感染病程时间较首次感染短[(7.03±2.30)d vs(8.94±3.02)d,t=6.739,P<0.001];二次感染发生肺炎较少[5.0%(9/180)vs 15.6%(28/180),χ^(2)=10.874,P=0.001];153例(85.0%)患者表示二次感染病情更轻。二元logistic回归结果发现,首次感染时出现咳嗽咯痰、周身不适及肺炎是新型冠状病毒重复感染的危险因素(OR=2.710,2.293,2.808,P<0.05),接种疫苗是避免重复感染的保护因素(OR=0.470,P=0.019)。结论新型冠状病毒再次感染症状普遍较轻,病程相对较短。对于脆弱人群,应积极接种新型冠状病毒疫苗,加强防护。

Objective To understand the clinical characteristics of novel coronavirus reinfection and explore the risk factors of novel coronavirus reinfection.Methods The clinical data of 340 patients with novel coronavirus infection who were admitted to the Fever Clinic of Beijing Traditional Chinese Medicine,Capital Medical University from December 2022 to January 2023 were included.The general characteristics,basic diseases,clinical symptoms,and examination results of the first and second infections in the non repeated infection group,the repeated infection group,and the repeated infection group were compared.Binary logistic multivariate analysis was used to explore the risk factors of novel coronavirus reinfection.Results In this study,340 patients with novel coronavirus infection were included,180 of whom were repeatedly infected.There was no statistically significant difference(all P>0.05)in terms of gender,age,body mass index(BMI),exercise,smoking,daily routine,and underlying disease between the recurrent infection group and the non recurrent infection group.However,the vaccination rate of the recurrent infection group was lower than that of the non recurrent infection group[80.0%(144/180)vs 88.0%(142/169),P<0.05];In the repeated infection group,157 cases(87.2%)were accompanied by overall discomfort(including headache,fatigue,muscle and joint pain),which was significantly higher than 122 cases(76.2%)in the non repeated infection group.The proportion of pneumonia occurring during the first infection was higher than that in the non repeated infection group[15.6%(28/180)],and the difference was statistically significant(P<0.05).The interval between the first and second infections in the repeated infection group was(166.2±8.3)days.Cough and phlegm were the main clinical manifestations of two infections;The duration of re infection was shorter than that of the first infection[(7.03±2.30)days vs(8.94±3.02)days,t=6.739,P<0.001];Secondary infections had less incidence of pneumonia[5.0%(9/180)vs 15.6%(28/180),χ^(2)=10.874,P=0.001];153 patients(85.0%)reported milder secondary infections.The results of binary logistic regression showed that cough,expectoration,body discomfort and pneumonia during the first infection were risk factors for repeated infection of novel coronavirus(OR=2.710,2.293,2.808,P<0.05),and vaccination was a protective factor to avoid repeated infection(OR=0.470,P=0.019).Conclusions The symptoms of novel coronavirus reinfection are generally mild and the course of disease is relatively short.For vulnerable people,novel coronavirus vaccine should be actively inoculated to strengthen protection.