上海市630例新型冠状病毒Omicron变异株感染者流行病学特征及影响核酸转阴时间的相关因素

Epidemiological Characteristics of 630 Patients with Novel Coronavirus Pneumonia in Shanghai to Analyze Related Factors Affecting the Time for Negative Nucleic Acid Negative Conversion

【目的】探讨上海市新型冠状病毒Omicron变异株感染者流行病学特征及影响核酸转阴时间的相关因素。【方法】回顾性分析上海黄浦方舱医院于2022年4月至5月收治的630例新型冠状病毒Omicron变异株感染患者的临床资料,按临床分型标准将其分为无症状/轻型组(n=543)和普通型组(n=87),根据胸部CT影像学诊断结果将患者分为A组(胸部CT平扫未见明显异常者,n=208)、B组(胸部影像呈现多发小斑片影及间质改变者,n=335)、C组(胸部影像呈现多双肺多发磨玻璃影、浸润影者,n=87)。比较各组胸部影像学特征及核酸检测结果,分析影响核酸转阴时间的相关因素。【结果】无症状/轻型组和普通型组不同性别、年龄、核酸基因分布比例,以及N基因Ct值、ORF基因Ct值比较,差异均有统计学意义(P<0.05)。A组、B组、C组不同年龄、核酸基因分布比例,以及N基因Ct值、ORF基因Ct值比较,差异均有统计学意义(P<0.05)。Logistic多因素回归分析显示,年龄、N基因Ct值、ORF基因Ct值为患者肺炎重症化的影响因素(P<0.05)。根据核酸转阴时间将其分为D组(核酸转阴时间<9 d,n=5)、E组(核酸转阴时间≥9 d,n=12)。D组、E组患者的年龄、入院时N基因Ct值、ORF基因Ct值比较,差异有统计学意义(P<0.05)。Logistic多因素回归分析显示,年龄、入院时N基因Ct值、ORF基因Ct值并不是影响患者核酸转阴时间的独立危险因素(均P>0.05)。【结论】新型冠状病毒Omicron感染者流行病学特征:性别、年龄及核酸基因Ct值对于临床分型有影响,而对病毒核酸转阴时间并无明显影响;患者肺部发生炎症改变的程度与年龄及病毒核酸含量相关。

【Objective】To analyze the epidemiological characteristics and the influencing factors of the time of nucleic acid turning negative for patients infected with the new coronavirus pneumonia Omicron variant in Shanghai,and to provide reference for the treatment of patients with new coronary pneumonia.【Methods】The epidemiological data of 630 new coronary pneumonia cases admitted to Shanghai Huangpu Fangcang Hospital from April to May,2022 were retrospectively studied.According to the clinical classification criteria,patients were divided into asymptomatic/mild group(n=543)and common group(n=87).Based on the chest CT imaging diagnosis results,the patients were divided into group A(no obvious abnormality in chest CT plain scan,n=208),group B(chest imaging showed multiple small patchy shadows and interstitial changes,n=335),and group C(chest imaging showed multiple ground-glass shadows and infiltration shadows in multiple lungs,n=87).Statistical analysis was carried out based on chest imaging characteristics and nucleic acid detection results.【Results】There were significant differences in gender,age,nucleic acid gene distribution ratio,N gene Ct value and ORF gene Ct value between the asymptomatic/mild group and the common group(P<0.05).There were significant differences in age,nucleic acid gene distribution ratio,N gene Ct value and ORF gene Ct value among group A,group B and group C(P<0.05).Logistic multivariate regression analysis showed that age,N gene Ct value and ORF gene Ct value were influencing factors for the severity of pneumonia in patients(P<0.05).According to the time of nucleic acid negative conversion,patients were divided into group D(nucleic acid negative conversion time<9 d,n=5)and group E(nucleic acid negative conversion time≥9 d,n=12).There were significant differences in age,N gene Ct value and ORF gene Ct value of patients in group D and group E(P<0.05).Logistic multivariate regression analysis showed that age,N gene Ct value and ORF gene Ct value at admission were not independent risk factors affecting the time for nucleic acid test to turn negative(all P>0.05).【Conclusion】Epidemiological characteristics of patients with new coronary pneumonia:gender,age and nucleic acid Ct value are meaningful for the clinical classification of new coronary pneumonia,but have no significant effect on the time of viral nucleic acid conversion to negative;The degree of inflammatory changes in the lungs of patients with new coronary pneumonia is related to age and viral nucleic acid content.