摘要
目的探讨新型冠状病毒疫苗突破性感染者的临床特征及重症发生的影响因素。方法回顾性收集2021年10月底甘肃省旅游传播链引发的完全接种新型冠状病毒灭活疫苗的突破性感染病例55例,其中非重症组41例(轻型10例,普通型31例),重症组14例(均为重型,危重型无),感染病毒株均鉴定为Delta变异株。分析其临床特征及重症的影响因素。结果与非重症组相比,重症组患者年龄增大、糖尿病、高血压、冠心病、慢性肺病等基础疾病发生率显著增高;干咳和咳痰症状发生率显著增高;确诊时血淋巴细胞数降低更显著,C-反应蛋白、肌酸激酶同工酶水平升高更显著;差异均有统计学意义(P<0.05)。多因素logistic回归分析显示,有基础疾病是发生重症的独立危险因素(β=-1.855,OR=0.156,P=0.018)。结论新型冠状病毒疫苗突破性感染重症患者年龄较大,基础疾病多,干咳、咳痰较多见,淋巴细胞减少更明显,C-反应蛋白及肌酸激酶同工酶升高更明显,可作为预测重症的危险信号,尤其对基础疾病多者,应十分重视、积极控制。
Objective To investigate the clinical characteristics of patients with SARS-CoV-2 vaccine breakthrough infection and the risk factors for severe cases.Methods By the end of October 2021,the data of 55 patients with vaccine breakthrough infection after completely vaccinated with SARS-CoV-2 inactivated vaccine,who were caused by transmission chain in tourism in Gansu Province were retrospectively anlyzed,including 41 cases in the non-severe group(10 cases of mild type,31 cases of common type)and 14 cases of severe type in the severe group.All the infected virus strains were identified as delta mutants.The clinical characteristics of all cases and risk factors of severe cases were analyzed.Results Compared with the non-severe group,the patients in the severe group were older,and the incidences of basic diseases such as diabetes,hypertension,coronary heart disease and chronic lung disease were significantly higher(P<0.05).In severe group,the incidence of dry cough and expectoration obviously increased,the number of blood lymphocytes decreased significantly,and levels of C-reactive protein(CRP)and creatine kinase isoenzyme-MB(CK-MB)increased more significantly compared with those in non-severe group(P<0.05).Multivariate logistic regression analysis showed that basic diseases were the independent risk factors for severe cases(β=-1.855,OR=0.156,P=0.018).Conclusion Severe patients with SARS-CoV-2 vaccine breakthrough infection are older with more basic diseases,dry cough and expectoration,more obvious decrease in lymphocyte,and more obvious increase in CRP and CK-MB,which can be used as a warning signal for severe cases.The great attention should be paid to these patients,meanwhile,active control should be taken.
作者
郭小玲
汪鲲
金杰
代丽丽
GUO Xiaoling;WANG Kun;JIN Jie;DAI Lili(Department of Infection,Pulmonery Hospital of Lanzhou,Lanzhou,Gansu 730046,China;不详)
出处
《中国临床研究》
CAS
2023年第4期572-575,580,共5页
Chinese Journal of Clinical Research
基金
兰州市科技发展指导性项目(2022-ZD-28)。
关键词
新型冠状病毒肺炎
疫苗
突破性感染
临床特征
重症
危险因素
Coronavirus disease 2019
Vaccine
Breakthrough infection
Clinical characteristics
Severe cases
Risk factors
