基于负二项回归模型的奥密克戎感染者核酸阴转所需时间的独立影响因素研究

Influencing factors of negative conversion time of nucleic acid among patients infected by omicron variant based on negative binomial regression model

目的使用负二项回归模型回顾性研究奥密克戎感染者的核酸阴转所需时间的影响因素。方法纳入2022年3月1日至2022年8月20日首都医科大学附属北京地坛医院收治的304例奥密克戎感染早期的患者,以新型冠状病毒核酸阴转所需时间为因变量,使用负二项回归模型研究新型冠状病毒核酸阴转时间的影响因素。基于一般临床资料和实验室检查结果等因素,首先使用单因素负二项回归模型对因素进行初步筛选,P<0.05的因素被纳入多因素建模,随后使用逐步回归筛选变量,依照AIC统计量确定最优模型。结果利用单因素联合构建对新型冠状病毒核酸阴转所需时间的多因素负二项回归模型,结果显示,男性新冠核酸阴转所需时间平均比女性短e^(0.107)(≈1.113)d;CT提示肺炎的患者新冠核酸阴转所需时间平均比CT未提示肺炎的患者长e^(0.201)(≈1.223)d;以感染BA.2.2毒株的患者为参照,感染BA.2毒株的患者新冠核酸阴转所需时间平均比感染BA.2.2毒株的患者长e^(0.103)(≈1.108)d,BA.5.2毒株的患者新冠核酸阴转所需时间平均比感染BA.2.2患者短e^(0.096)(≈1.101)d。结论本研究发现性别、肺部CT为病毒性肺炎表现、BA.2毒株和BA.5.2毒株被认为是新型冠状病毒核酸阴转所需时间的影响因素。目前,在新型冠状病毒疫情常态化管理的情况下,确定新型冠状病毒核酸阴转所需时间的影响因素,可为指导临床工作中患者分层救治及预后评估提供依据。

Objective To study the influencing factors of negative conversion time of nucleic acid among patients infected by omicron variant using negative binomial regression model.Methods A total of 304 patients at early stage of infection by omicron variant who admitted to Beijing Ditan Hospital affiliated to Capital Medical University from March 1,2022 to August 20,2022 were enrolled in the study.The negative conversion time of severe acute respiratory coronavirus 2(SARS-CoV-2)nucleic acid was set as the dependent variable.The negative binomial regression model was used to study the influencing factors of negative conversion time of SARS-CoV-2 nucleic acid.The single-factor negative binomial regression model was used to initially screen the factors based on general clinical data and laboratory examination results.The factor with P<0.05 were included in the multi-factor model followed by step-by-step regression in screening variables.The statistical results of AIC were used for optimized model.Results The multi-factor negative binomial regression model was built based on joint construction of single-factors.The results indicated that the negative conversion time of SARS-CoV-2 nucleic acid in males was shorter than that of females by e^(0.107)(≈1.113)d.The negative conversion time of SARS-CoV-2 nucleic acid in patients with the sign of pneumonia on CT was longer than that in patients without the sign by e^(0.201)(≈1.223)d.With the patients infected with BA.2.2 strain as the reference,the average negative conversion time of SARS-CoV-2 nucleic acid in patients infected with BA.2 strain was on longer than that in patients infected with BA.2.2 strain by e^(0.103)(≈1.108)d.The average negative conversion time of SARS-CoV-2 nucleic acid in patients infected with BA.5.2 strain was shorter than that in patients infected with BA.2.2 strain by e^(0.096)(≈1.101)d.Conclusions This study found that gender,manifestations of viral pneumonia on lung CT as well as infections by BA.2 strains and BA.5.2 strains were the influencing factors of negative conversion time of SARS-CoV-2 nucleic acid.Under present normalized management of coronavirus disease 2019(COVID-19)epidemics,estimation of negative conversion time of SARS-CoV-2 nucleic acid provided guidance for the layered treatment of patients and basis for evaluating the prognosis in clinical practice.