福建省居民新型冠状病毒肺炎感染影响因素病例对照研究

陈光敏; 蓝梅芳; 陈晓红; 谢剑锋; 欧剑鸣; 郑奎城

doi:10.11847/zgggws1135552

福建省居民新型冠状病毒肺炎感染影响因素病例对照研究

Influencing factors of COVID-19 infection among close contacts of confirmed COVID-19 cases in Fujian province, China: a case-control study

摘要

摘要:
目的了解福建省居民新型冠状病毒肺炎（新冠肺炎）感染的影响因素，为调整新冠肺炎防控措施和干预策略提供科学依据。
方法采用病例对照研究方法对福建省2020年1 — 3月报告的103例主动配合调查的感染来源为本地或不明确的境内确诊病例和阳性检测者以及随机抽取的与确诊病例或阳性检测者在同一县区且经定点隔离医学观察期满并在隔离期间第1、7和14 d咽拭子聚合酶链反应（PCR）检测新型冠状病毒核酸为阴性的430名密切接触者进行问卷调查。
结果病例组新冠肺炎确诊病例和阳性检测者患慢性病、与新冠肺炎患者共同居住生活、与新冠肺炎患者进行日常交谈、接触过出现症状的新冠肺炎患者、接触的新冠肺炎患者有发热症状、与新冠肺炎患者室内密闭1 m单次接触 ≥ 1 h、与新冠肺炎患者室内密闭1 m内多次累计接触 ≥ 5 h、与新冠肺炎患者室内密闭2 m内多次累计接触 ≥ 10 h、与新冠肺炎患者在外开阔环境1 m以单次接触 ≥ 2 h和与新冠肺炎患者在外开阔环境1 m内多次累计接触 ≥ 10 h的比例分别为37.86 %、35.92 %、40.78 %、71.84 %、48.54 %、59.22 %、40.78 %、12.62 %、5.83 %和3.88 %，均高于对照组阴性密切接触者的24.65 %、15.35 %、23.72 %、50.93 %、25.81 %、30.47 %、14.65 %、6.74 %、0.47 %和0.47 %（均P < 0.05）；现在吸烟、经常洗手、洗手时几乎每次都使用肥皂或洗手液、每次外出都佩戴口罩、佩戴口罩前进行密闭检查、口罩每次都进行更换、与新冠肺炎患者仅共处同一个密闭空间无直接接触、与新冠肺炎患者接触时采取防护措施、接触可疑新冠肺炎患者后采取洗手消毒措施和在发病2周前去过农贸市场的比例分别为8.74 %、59.22 %、32.04 %、38.83 %、13.59 %、26.21 %、10.68 %、39.81 %、6.80 %和67.96 %，均低于对照组阴性密切接触者的26.74 %、74.65 %、56.51 %、70.00 %、29.77 %、36.98 %、28.14 %、55.81 %、28.14 %和81.40 %（均P < 0.05）。多因素非条件logistic回归分析结果显示，接触过出现症状的新冠肺炎患者和与新冠肺炎患者室内密闭1 m内单次接触 ≥ 1 h是福建省居民新冠肺炎感染的危险因素，每次外出都佩戴口罩、佩戴口罩前进行密闭检查和接触可疑新冠肺炎患者后采取洗手消毒措施是福建省居民新冠肺炎感染的保护因素。
结论是否每次外出都佩戴口罩、佩戴口罩前是否进行密闭检查、是否接触过出现症状的新冠肺炎患者、接触可疑新冠肺炎患者后是否采取洗手消毒措施和是否与新冠肺炎患者室内密闭1 m内单次接触 ≥ 1 h是福建省居民新冠肺炎感染的主要影响因素。

Abstract:
Objective To explore influencing factors of coronavirus disease 2019 (COVID-19) infection among close contacts of COVID-19 cases in Fujian province for providing evidences to the development of effective control measures and intervention strategies.
Methods We recruited 103 locally laboratory-confirmed COVID-19 cases reported from January through March, 2020 in Fujian province; the age (± 5 years)- and region (in the same county/district)-matched controls were 430 persons randomly selected from close contacts completing medical observation in designated quarantine sites and with negative results of throat swab coronavirus nucleic acid detection at 1-, 7-, 14-day of isolation period. The participants′ information was collected online with a self-designed questionnaire. Logistic regression was conducted to analyze influencing factors of COVID-19 infection.
Results There were no significant differences in gender, age, and body mass index between cases and controls (all P > 0.05). Compared to those of the controls, the proportions of the cases reporting following conditions/behaviors were significantly higher: with chronic disease (37.86% vs. 24.65%), co-habitation with confirmed COVID-19 patient (35.92% vs. 15.35%), having daily conversation with confirmed COVID-19 patient (40.78% vs. 23.72%), contacting with symptomatic COVID-19 patient (71.84% vs. 50.93%), contacting with fever COVID-19 patient (48.54% vs. 25.81%), contacting one-time with COVID-19 patient at a distance of one meter or less in close indoor environment for one hour and more (59.22% vs. 30.47%), contacting with COVID-19 patient several times at a distance of one meter or less in close indoor environment cumulatively for 5 hours and more (40.78% vs. 14.65%), contacting with COVID-19 patient several times at a distance of 2 meters or less in close indoor environment cumulatively for 10 hours and more (12.62% vs. 6.74%), contacting with COVID-19 patient at a distance of one meter or less in outdoor environment for 2 hours and more only one time (5.83% vs. 0.47%), and contacting with COVID-19 patient several times at a distance of one meter or less in outdoor environment cumulatively for 10 hours and more (3.88% vs. 0.47%) (all P < 0.05); but there were significantly lower proportions of the cases reporting current smoking (8.74% vs. 26.74%), washing hands frequently (59.22% vs. 74.65%), using soap or liquid soap almost every time when washing hands (32.04% vs. 56.51%), wearing a mask every time when going out (38.83% vs. 70.00%), checking the quality of a mask to be used (13.59% vs. 29.77%), using a new mask all the time when needing mask-wearing (26.21% vs. 36.98%), without direct contact with COVID-19 patient when coexisting in the same close indoor environment with the patient (10.68% vs. 28.14%), taking protective measures when contacting with COVID-19 patient (39.81 vs. 55.81%), conducting hand-washing and other disinfection procedures after contacting with suspected COVID-19 patient (6.80% vs. 28.14%), and ever going to farmers' market two weeks before the disease incidence (67.96% vs. 81.40%) (P < 0.05 for all). Unconditional multivariate logistic regression analysis revealed that ever contacting with symptomatic COVID-19 patient and contacting one-time with COVID-19 patient at a distance of one meter or less in close indoor environment for one hour and more were significant risk factors of COVID-19 infection; the analysis also indicated that wearing a mask every time when going out, checking the quality of a mask to be used, and conducting hand-washing and other disinfection procedures after contacting with suspected COVID-19 patient were significant protective factors against COVID-19 infection.
Conclusion Mask-wearing when going out, checking the quality of a mask to be used, contacting with symptomatic COVID-19 patient, conducting hand-washing and other disinfection procedures after contacting with suspected COVID-19 patient, and contacting one-time with COVID-19 patient at a distance of one meter or less in close indoor environment for one hour and more are significant influencing factors of COVID-19 infection among close contacts of confirmed COVID-19 cases in Fujian province.

HTML全文

参考文献(20)

施引文献

资源附件(0)