奥密克戎低流行时期新型冠状病毒肺炎与甲型流感的流行特点分析

Analysis of epidemic characteristics of COVID-19 and influenza A during the low prevalence period of Omicron

目的:分析奥密克戎(Omicron)低流行时期新型冠状病毒肺炎(COVID-19)和甲型流感(Inf A)的流行特点。方法:分析2023年1—4月天津市第一中心医院发热门诊不同呼吸道病毒的每日检出率并进行相关检验;根据感染情况分为COVID-19组(n=190)和Inf A组(n=376),收集患者的基本资料和实验室检测结果并进行比较。结果:发热门诊检出的呼吸道病毒以新型冠状病毒(SARS-CoV-2)和甲型流感病毒(IAV)为主,SARS-CoV-2检出率整体呈下降趋势(Z=-5.004),总阳性率为8.64%(520/6019),IAV检出率整体呈上升趋势(Z=6.132),总阳性率为48.17%(3221/6687),在520例SARS-CoV-2阳性患者中有52例合并IAV感染,合并感染率为10.00%(52/520)。与Inf A组相比,COVID-19组年龄较大(Z=-4.00,P<0.05),性别比例差异无统计学意义;在血常规指标中,与Inf A组相比,COVID-19组红细胞分布宽度变异系数(RDW-CV)、血小板(PLT)计数、血小板分布宽度(PDW)、白细胞计数(WBC)、中性粒细胞计数(NC)和中性粒细胞与淋巴细胞比值(NLR)较高(Z=-3.68、t=-2.25、Z=-4.50、-2.38、-3.32、-3.97,均P<0.05),红细胞计数(RBC)、红细胞压积(HCT)、血红蛋白浓度(HGB)和淋巴细胞计数(LC)较低(Z=-2.79、-3.13、-2.80,均P<0.05);在肝功能指标方面,COVID-19组总蛋白(TP)和白蛋白(ALB)水平均明显低于Inf A组(t=2.93、3.12,均P<0.05);与Inf A组相比,COVID-19组血糖(GLU)水平更高(t=-2.80,P<0.05);而两组的肾功能指标和炎症指标C反应蛋白(CRP)差异无统计学意义。结论:在Omicron低流行时期Inf A出现高流行趋势,并存在合并感染的风险。两种疾病虽然症状相似但实验室指标存在明显差异。

Objective:To analyze the epidemic characteristics of novel coronavirus(COVID-19)and influenza A(Inf A)during the low prevalence period of Omicron.Methods:Trend test was conducted on the daily detection rates of different respiratory viruses in the fever clinic of Tianjin First Central Hospital from January to April 2023.According to patients′infection condition,they were divided into COVID-19 group(n=190)and Inf A group(n=376).Their basic information and laboratory test results were collected and compared.Results:The respiratory viruses detected in the fever clinics were mainly severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)and influenza A virus(IAV).The overall detection rate of SARS-CoV-2 was decreasing(Z=-5.004),with a total positive rate of 8.64%(520/6019).The overall detection rate of IAV was increasing(Z=6.132),with a total positive rate of 48.17%(3221/6687).Among 520 SARS-CoV-2 positive patients,52 patients were co-infected with IAV,with a co-infection rate of 10.00%(52/520).Compared with Inf A group,the COVID-19 group had a higher age(Z=-4.00,P<0.05),and there was no statistically significant difference in gender ratio.In terms of blood routine indicators,compared with Inf A group,the COVID-19 group′s coefficient of variation of red blood cell distribution width(RDW-CV),platelet(PLD)count,platelet distribution width(PDW),white blood cell count(WBC),neutrophil count(NC)and neutrophil lymphocyte ratio(NLR)were higher(Z=-3.68,t=-2.25,Z=-4.50,-2.38,-3.32,-3.97,all P<0.05),while red blood cell count(RBD),hematocrit(HCT),hemoglobin concentration(HGB)and lymphocyte(LC)count were lower(Z=-2.79,-3.13,-2.80,all P<0.05).In terms of liver function indicators,the total protein(TP)and albumin(ALB)levels of patients in the COVID-19 group were significantly lower than those in the Inf A group(t=2.93,3.12,both P<0.05).Compared with Inf A patients,patients infected with SARS-CoV-2 had higher blood glucose(GLU)levels(t=-2.80,P<0.05).However,there was no statistically significant difference in renal function indicators and inflammatory indicator C-reactive protein(CRP)between the two groups.Conclusion:During the low prevalence of Omicron,there is a high trend of Inf A and a risk of co-infection.Although the symptoms of the two diseases are similar,there are significant differences in laboratory indicators.