2022年末上海某三甲医院工作人员新型冠状病毒感染再感染的严重程度研究

Severity of COVID-19 reinfection among healthcare workers in a grade A tertiary hospital in Shanghai by the end of 2022

【目的】描述新型冠状病毒感染(COVID⁃19)从“乙类甲管”调整到“乙类乙管”新政策后的流行特征,探讨既往自然感染新型冠状病毒(SARS⁃CoV⁃2)对再感染者常见症状的保护作用。【方法】以2022年12月4日—2023年1月11日上海某三甲医院感染SARS⁃CoV⁃2的工作人员为研究对象,采集其人口学特征、临床症状、疾病史和SARS⁃CoV⁃2疫苗接种史等。分析感染者流行病学特征,比较初次与再次感染者的临床症状和严重程度的差异。【结果】共纳入病例2704例,其中再感染45例,男性605例(22.4%),平均年龄(34.9±9.1)岁,医生608例(22.5%),护士1275例(47.2%),COVID⁃19疫苗接种≥3剂2351例(86.9%)。轻/中型、无症状感染者、发热、头痛、干咳、咳痰和胸闷人数分别是2704(100.0%)、92(3.4%)、2385(88.2%)、2066(76.4%)、1642(60.7%)、1807(66.8%)和439(16.2%)。再感染是发热(OR=0.161,P<0.001)、头痛(OR=0.320,P<0.001)和热峰(β=-0.446,P<0.001)的保护因素。【结论】实行“乙类乙管”新政策后,上海某三甲医院工作人员COVID⁃19发病以轻/中型为主,再感染者临床症状较轻,但无症状比例较少。

[Objective]To describe the epidemic characteristics of COVID-19 after policy adjustment from“Category B notifiable disease with category A management”to“Category B notifiable disease with category B management”,and to explore the protective effect of previous infection with SARS-CoV-2 on common symptoms of reinfection.[Methods]Healthcare workers infected with SARS-CoV-2 in a grade A tertiary hospital in Shanghai were included in the study from December 4,2022 to January 11,2023.Data on demographic characteristics,clinical symptoms,medical history,and COVID-19 vaccination history were collected.We determined the epidemiological curve and characteristics,and then compared the difference in the severity of clinical symptoms between primary and reinfection subjects.[Results]A total of 2704 cases were included in the study,of which 45 had reinfection,605(22.4%)were males,608(22.5%)were doctors,1275(47.2%)were nurses,and 2351(86.9%)received≥3 doses of COVID-19 vaccination.The average age of these healthcare workers was(34.9±9.1)years old.The number of cases with mild/moderate illness,asymptomatic infection,fever,headache,dry cough,expectoration,and chest tightness were 2704(100.0%),92(3.4%),2385(88.2%),2066(76.4%),1642(60.7%),1807(66.8%),and 439(16.2%),respectively.Reinfection was a protective factor for fever(OR=0.161,P<0.001),headache(OR=0.320,P<0.001),and peak body temperature(β=-0.446,P<0.001).[Conclusion]Following the COVID-19 policy adjustment as a category B notifiable disease,healthcare workers at a grade A tertiary hospital in Shanghai predominantly experiences mild to moderate COVID-19 symptoms.Reinfection results in milder clinical manifestations,with a lower proportion of being asymptomatic.