上海地区SARS-CoV-2组粒变异患者临床特征及转归:单中心、回顾性、观察性研究

Da-Wei Yang , Jing Li , Li Feng , Hui-Fen Weng , Min-Jie Ju , Hao Wang , Yi-Chen Jia , Xiao-Dan Wang , Jia Fan , Zuo-Qin Yan , Xing-Wei Lu , Wei Yang , Yin Wu , Zheng-Guo Chen , Qi-Yun Jiang , Jian-Wei Xuan , Qiqing Shi , Hao Fang
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摘要

2022年3月,上海发生了严重的SARS-CoV-2欧米克隆变种疫情。本研究旨在确定患有Omicron变异的住院患者的疾病严重程度、临床特征和临床结局,并评估一剂、两剂和三剂灭活疫苗在降低病毒载量、病程、ICU入院率和严重疾病方面的有效性。方法回顾性队列分析2022年3月至2022年6月在上海老年医学中心住院的5170例(≥18岁)确诊为严重急性呼吸综合征冠状病毒2型阳性的成人患者。从电子病历中提取人口统计信息、实验室数据、免疫状况、临床特征和结果。结果5170例入组患者中位年龄为53岁,男性2861例(55.3%)。71.0%为轻症,其中咳嗽(1137例[22.0%])、发热(592例[11.5%])、喉咙痛(510例[9.9%])、乏力(334例[6.5%])是患者首次入院时最常见的症状。中位住院时间为8.7±4.5天。在多因素logistic分析中,与低剂量疫苗相比,加强疫苗接种可显著减少ICU入院率,降低COVID-19结局的严重程度(OR = 0.75, 95% CI, 0.62-0.91, P≤0.005;OR = 0.99, 95% CI, 0.99 - 1.00, p <0.001)。结论感染SARSCoV-2组粒变异的患者临床特征较轻,接种疫苗后降低病毒载量的时间较短。
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Clinical characteristics and outcome of patients with SARS-CoV-2 Omicron variant in Shanghai: A single center, retrospective, observational study

Background

In March 2022, a severe outbreak of the SARS-CoV-2 Omicron variant occurred in Shanghai. This study aimed to determine disease severity, clinical features, clinical outcome in hospitalized patients with the Omicron variant and evaluate the effectiveness of one-dose, two-dose, and three-dose inactivated vaccines in reducing viral loads, disease course, ICU admissions and severe diseases.

Methods

Retrospective cohort analysis was performed on 5,170 adult patients (≥18 years) identified as severe acute respiratory syndrome coronavirus 2 positive with Reverse Transcription Polymerase Chain Reaction admitted at Shanghai Medical Center for Gerontology between March 2022 and June 2022. Demographic information, laboratory data, immunization status, clinical characteristics and outcomes were extracted from electronic medical records.

Results

Among 5,170 enrolled patients, the median age was 53 years, and 2,861 (55.3 %) were male. 71.0 % were mild COVID-19 cases, and cough (1,137 [22.0 %]), fever (592 [11.5 %]), sore throat (510 [9.9 %]), and fatigue (334 [6.5 %]) were the most common symptoms on the patient’s first admission. The median length of hospital stay was 8.7 ± 4.5 days. In multivariate logistic analysis, booster vaccination can significantly reduce ICU admissions and decrease the severity of COVID-19 outcome when compared with less doses of vaccine (OR = 0.75, 95 %CI, 0.62–0.91, P ≤ 0.005; OR = 0.99, 95 %CI, 0.99–1.00, p < 0.001).

Conclusions

In summary, the most of patients who contracted SARSCoV-2 omicron variant had mild clinical features and patients with vaccination took less time to lower viral loads.

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