摘要
目的:探索新型冠状病毒肺炎首发临床症状特征,提高新冠肺炎病例的识别能力,防止疾病的进一步传播。方法:对2020年1月5日至4月7日五个地区报告的559例出现症状的密切接触者进行研究,分析新冠病毒核酸检测阳性和新冠病毒感染者发展为重症的影响因素。结果:共559例密切接触者在医学观察期间出现临床症状,平均年龄为43.54岁,核酸阳性者320例,核酸阴性者239例。新冠病毒核酸阳性者常见的首发症状为发热(50.31%)、咳嗽(44.69%)、乏力(14.06%)和咽部不适(10.63%)。多因素logistic回归分析显示,出现症状者中有基础疾病者新冠病毒核酸检测阳性的风险是无基础疾病者的2.70倍(95%CI:1.52~4.98)。首发临床症状表现出乏力、头晕头痛、寒战的密切接触者新冠病毒核酸检测阳性的风险分别是未表现出相应症状的4.82倍(95%CI:2.29~11.41)、2.59倍(95%CI:1.09~6.84)和9.34倍(95%CI:1.74~173.18)。≥60岁的感染者发展为重症的风险是<60岁人群的8.78倍(95%CI:4.12~19.73)。男性感染者发展为重症的风险是女性的2.52倍(95%CI:1.21~5.47)。有基础疾病者的感染者发展为重症的风险是无基础疾病者的3.56倍(95%CI;1.55~8.24)。首发临床症状表现为发热、乏力的感染者发展为重症的风险分别是未表现出相应症状的2.91倍(95%CI:1.34~6.65)和3.79倍(95%CI:1.47~9.65)。结论:首发症状表现出乏力、头晕头痛、寒战者要警惕新冠病毒感染的风险,首发症状表现为发热、乏力的感染者要警惕发展为重症的风险,进一步提高患者就诊意识和病例识别能力,及时发现感染者。
Objective To explore the characteristics of the initial clinical symptoms of coronavirus disease 2019(COVID-19),so as to improve the identification ability of COVID-19 and prevent the disease from further spreading.Methods A total of 559 close contacts with symptoms,reported from January 5 to April 72020 in five regions,were studied.The factors influencing the positive nucleic acid test of the SARS-CoV-2 and the developing into severe cases among COVID-19 cases were analyzed based on initial clinical symptoms.Results Among 559 symptomatic close contacts,the average age was 43.54 years There were 320 positive nucleic acid cases and 239 negative nucleic acid cases.The common initial symptoms of COVID-19 cases were fever(50.31%),cough(44.69%),fatigue(14.06%)and pharynx ministry unwell(10.63%).Multivariate logistic regression analysis showed that the risk of SARS-CoVL2 nucleic acid test positive among symptomatic close contacts with underlying diseases was 2.70 times(95%CT:1.52-4.98)as high as the risk among those without underlying diseases.The risks of SARS-CoV1!nucleic acid test positive among close contacts with fatigue,dizziness and headache and chill as initial symptoms were 4.82 times(95%CI:2.29-11.41),2.59 times(95%CI:1.09-6.84)and 9.34 times(95%CI:1.74-173.18)as high as the risk among those without corresponding symptoms,respectively.Therisk of developing into severe cases for people aged≥60 years was 8.78 times(95%CI:4.12-19.73)ashigh as the risk among those aged<60 years.The risk of developing into severe cases in males was 2.52times(95%CI:1.21-5.47)as high as the risk among females.The risk of COVID-19 cases with underlyingdiseases developing into severe cases were 3.56 times(95%CI:1.55-8.24)as high as the risk among thosewithout underlying diseases.The risks of developing into severe cases among cases with initial symptomsof fever and fatigue were 2.91 times(95%CI:1.34-6.65)and 3.79 times(95%CI:1.47-9.65)as high asthe risks among those without corresponding symptoms,respectively.Conclusions Close conta
作者
任敏睿
汤巧雨
高玺玉
刘凤凤
张业武
孙军玲
常昭瑞
Ren Minrui;Tang Qiaoyu;Gao Xiyu;Liu Fengfeng;Zhang Yewu;Sun Junling;Chang Zhaorui(Division of Infectious Disease,Key Laboratory of Surveillance and Early Warning on Infectious Disease,Chinese Center far Disease Control and Prevention,Beijing 102206,China;Information Center,Chinese Center far Disease Control and Prevention,Beijing 102206,China)
出处
《国际病毒学杂志》
2021年第3期196-200,共5页
International Journal of Virology
基金
国家重点研发计划(2021YFF0306000)
国家自然科学基金(82041029)。
