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≥ 60岁老年人群感染不同新冠病毒变异株临床症状及严重程度分析

王海峰 李亚飞 潘静静 尤爱国 王若琳 范威 王文华 王莹莹 叶莹 黄学勇 郭万申

王海峰, 李亚飞, 潘静静, 尤爱国, 王若琳, 范威, 王文华, 王莹莹, 叶莹, 黄学勇, 郭万申. ≥ 60岁老年人群感染不同新冠病毒变异株临床症状及严重程度分析[J]. 中国公共卫生, 2022, 38(8): 968-974. doi: 10.11847/zgggws1138940
引用本文: 王海峰, 李亚飞, 潘静静, 尤爱国, 王若琳, 范威, 王文华, 王莹莹, 叶莹, 黄学勇, 郭万申. ≥ 60岁老年人群感染不同新冠病毒变异株临床症状及严重程度分析[J]. 中国公共卫生, 2022, 38(8): 968-974. doi: 10.11847/zgggws1138940
WANG Hai-feng, LI Ya-fei, PAN Jing-jing, You Aiguo, Wang RuoLin, Fan Wei, Wang Wenhua, Wang Yingying, Ye Ying, Huang Xueyong, Guo Wanshen. Clinical symptoms and severity of elderly COVID-19 patients infected with different SARS-CoV-2 variants[J]. Chinese Journal of Public Health, 2022, 38(8): 968-974. doi: 10.11847/zgggws1138940
Citation: WANG Hai-feng, LI Ya-fei, PAN Jing-jing, You Aiguo, Wang RuoLin, Fan Wei, Wang Wenhua, Wang Yingying, Ye Ying, Huang Xueyong, Guo Wanshen. Clinical symptoms and severity of elderly COVID-19 patients infected with different SARS-CoV-2 variants[J]. Chinese Journal of Public Health, 2022, 38(8): 968-974. doi: 10.11847/zgggws1138940

≥ 60岁老年人群感染不同新冠病毒变异株临床症状及严重程度分析

doi: 10.11847/zgggws1138940
基金项目: 河南省医学科技攻关计划省部共建项目(SBGJ202001003);河南省科技厅重大专项(211100311000);河南省医学科技攻关计划联合共建项目(LHGJ20210144);河南省中青年卫生健康科技创新领军人才培训项目(YXKC2020006)
详细信息
    作者简介:

    王海峰(1976 – ),河南洛阳人,男,副主任医师,硕士,主要从事传染病预防与控制工作

    通讯作者:

    郭万申,Email:gwscdc@126.com

  • 中图分类号: R 183

Clinical symptoms and severity of elderly COVID-19 patients infected with different SARS-CoV-2 variants

Funds: Fund programs:Joint Construction Project of Henan Medical Science and Technology Research Plan(SBGJ202001003);Major Special Projects of Henan Provincial Department of Science and Technology(211100311000);Joint Construction Project of Henan Medical Science and Technology Research Plan (LHGJ20210144);Henan Province Young and Middle-aged Health Science and Technology Innovation Leader Training Project (YXKC2020006)
More Information
  • 摘要:   目的   比较新冠病毒德尔塔变异株、奥密克戎变异株BA.1和BA.2在老年感染者中临床表现和严重程度差异。  方法   收集2022年河南省4次大规模新冠肺炎本土疫情中 ≥ 60岁老年感染者的社会人口学信息和发病资料,采用χ2、Fisher精确概率法比较不同变异株感染者发病差异,使用多因素logistic回归分析新冠肺炎重型或危重型的影响因素。  结果   共纳入老年新冠病毒感染者234例,其中德尔塔变异株感染者118例,奥密克戎变异株感染者116例(BA.1 36例、BA.2 80例);56.8 %的感染者为女性,47.6 %有基础性疾病,88.0 %接种了新冠病毒疫苗;德尔塔变异株感染者出现临床症状的比例高于奥密克戎变异株(34.7 % vs. 19.0 %,χ2 = 7.404,P = 0.007),临床表现均以咳嗽、咽痛、咽干等上呼吸道症状和发热、乏力等全身症状为主;德尔塔变异株感染者发展成重型或危重型的比例高于奥密克戎变异株感染者(12.7 % vs. 1.7 %,P = 0.002),多因素logistic回归分析结果显示,感染德尔塔变异株(OR = 5.7,95 % CI = 1.1~31.2),≥ 80岁年龄组(OR = 8.4,95 % CI = 2.0~34.4),存在运动障碍(OR = 5.3,95 % CI = 1.5~18.3)和糖尿病(OR = 5.7,95 % CI = 1.1~31.3)是 ≥ 60岁老年感染者发展成新冠肺炎重型或危重型的危险因素。  结论   ≥ 60岁老年人群感染不同新冠病毒变异株,在临床症状、重型或危重型发生风险上存在差异,感染德尔塔变异株、高龄和患有基础性疾病是发展成重型或危重型的危险因素。
  • 表  1  ≥ 60岁新冠病毒感染者社会人口学特征分布情况(N = 234)

    特征德尔塔变异株奥密克戎变异株总计
    合计BA.1BA.2
    n%n%n%n%n%
    性别
     男5143.25043.11233.33847.510143.2
     女6756.86656.92466.74252.513356.8
    年龄组(岁)
     60~696454.26757.82158.34657.513156.0
     70~792420.33832.81336.12531.36226.5
    ≥ 803025.4119.525.6911.34117.5
    地区
     农村7664.411094.83494.47695.018679.5
     城市4235.665.225.645.04820.5
    职业
     农民8471.210086.23494.46682.518478.6
     家务及待业1512.754.300.056.3208.5
     离退休97.654.312.845.0146.0
     其他108.565.212.856.3166.8
    下载: 导出CSV

    表  2  ≥ 60岁新冠病毒感染者基础性疾病发生情况(N = 234)

    疾病德尔塔变异株奥密克戎变异株总计
    合计BA.1BA.2
    n%n%n%n%n%
    有基础性疾病
     否4739.85547.42158.33442.510243.6
     是5849.25648.31541.74151.311448.7
     不详1311.054.30056.3187.7
    运动障碍
     否10286.410086.23186.16986.320286.3
     是1613.61613.8513.91113.83213.7
    高血压
     否9479.78775.02877.85973.818177.4
     是2420.32925.0822.22126.35322.6
    心脑血管疾病 a
     否9580.59481.03494.46075.018980.8
     是2319.52219.025.62025.04619.2
    糖尿病
     否11294.910388.83391.77087.521591.9
     是65.11311.238.31012.5198.1
    肺部疾病
     否11496.611599.13597.280100.022997.9
     是43.410.912.800.052.1
    肿瘤
     否11698.311397.43494.47998.822997.9
     是21.732.625.611.252.1
      注:a 奥密克戎变异株BA.1与BA.2比较,P < 0.05。
    下载: 导出CSV

    表  3  ≥ 60岁新冠病毒感染者新冠病毒疫苗接种情况(N = 234)

    项目德尔塔变异株奥密克戎变异株总计
    合计BA.1BA.2
    n%n%n%n%n%
    接种新冠病毒疫苗 a
     否2117.876.038.345.02812.0
     是9782.210994.03391.77695.020688.0
    全程接种新冠病毒疫苗 a
     否2622.0119.5513.967.53715.8
     是9278.010590.53186.17492.519784.2
    接种新冠病毒疫苗加强针 ab
     否10689.87362.93494.43948.817976.5
     是1210.24337.125.64151.25523.5
    最后1剂接种时间在确诊90 d以内 a
     否9580.57665.53086.34657.517173.1
     是2319.54034.5616.73442.52326.9
      注:a 德尔塔变异株与奥密克戎变异株(合计)比较,P < 0.05;b 奥密克戎变异株BA.1与BA.2比较,P < 0.05。
    下载: 导出CSV

    表  4  ≥ 60岁新冠病毒感染者临床症状表现(N = 234)

    项目德尔塔变异株奥密克戎变异株总计
    合计BA.1BA.2
    n%n%n%n%n%
    咳嗽 a2521.297.838.367.53414.5
    发热1512.786.912.878.8239.8
    咽痛、咽干1311.076.025.656.3208.5
    乏力43.454.325.633.893.8
    头晕、头痛 b75.932.638.300104.3
    恶心、呕吐00.021.712.811.320.9
    鼻塞流涕43.410.90011.352.1
    腹泻43.400.0000041.7
    合计 a4134.72219.09251316.96326.9
      注:a 德尔塔变异株与奥密克戎变异株(合计)比较,P < 0.05;b 奥密克戎变异株BA.1与BA.2比较,Fisher精确概率P < 0.05。
    下载: 导出CSV

    表  5  患有基础性疾病感染者重型或危重型分布情况(N = 234)

    项目非重型或危重型重型或危重型Pa
    n%n%
    基础性疾病0.004
     否10098.022.0
     是9986.81513.2
     不详18100.000.0
    运动障碍0.003
     否19295.0105.0
     是2578.1721.9
    高血压0.228
     否17093.9116.1
     是4788.7611.3
    心脑血管疾病0.026
     否17994.7105.3
     是3884.4715.6
    糖尿病0.149
     否20193.5146.5
     是1684.2315.8
    肺部疾病0.316
     否21393.0167.0
     是480.0120.0
    肿瘤0.316
     否21393.0167.0
     是480.0120.0
      注:a Fisher精确概率法。
    下载: 导出CSV

    表  6  不同新冠疫苗接种情况感染者临床表现严重程度分布(N = 234)

    项目非重型或危重型重型或危重型P a
    n%n%
    接种新冠病毒疫苗0.13
     否2485.7414.3
     是19393.7136.3
    全程接种新冠病毒疫苗0.008
     否3081.1718.9
     是18794.9105.1
    加强接种新冠病毒疫苗0.015
     否16290.5179.5
     是5510000
    最后1剂接种时间是否在检测阳性90 d内0.008
     否15490.1179.9
     是6310000
      注:a Fisher精确概率法。
    下载: 导出CSV

    表  7  ≥ 60岁新冠病毒感染者临床表现严重程度影响因素分析

    自变量参照组β$S_{\bar x}$Wald χ2POR95 % CI
    变异株 德尔塔 奥密克戎合计 1.7 0.9 4.1 0.043 5.7 1.1~31.2
    年龄组(岁) 70~79 60~69 0.8 0.8 0.9 0.343 2.2 0.4~11.6
    ≥ 80 2.1 0.7 8.7 0.003 8.4 2.0~34.4
    运动障碍 1.7 0.6 6.9 0.009 5.3 1.5~18.3
    糖尿病 1.7 0.9 4.1 0.043 5.7 1.1~31.3
    下载: 导出CSV
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  • 收稿日期:  2022-04-25
  • 网络出版日期:  2022-04-29
  • 刊出日期:  2022-08-31

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