江苏省扬州市德尔塔毒株新型冠状病毒肺炎患者早期临床特征分析

Analysis in early clinical characteristics of Coronavirus Disease 2019 patients with Delta strain in Yangzhou City of Jiangsu Province

  • 摘要:
      目的  分析确诊感染德尔塔(Delta)毒株新型冠状病毒肺炎(COVID-19)患者的流行病学特点、临床特征和辅助检查结果。
      方法  纳入2021年7月29日-8月16日在扬州市苏北人民医院发热门诊确诊的75例Delta毒株COVID-19患者,并与2020年2月扬州市37例确诊原始毒株COVID-19患者进行比较,包括流行病学特点、临床特征和辅助检查结果。
      结果  75例Delta毒株感染患者中,男26例,女49例,中位年龄50.7(35.0,67.0)岁,其中41~64岁者24例(32.0%),≥ 65岁者28例(37.3%);原始毒株感染患者中位年龄46.2(36.5,55.5)岁,其中41~64岁者20例(54.1%)。47例(62.7%)确诊Delta毒株COVID-19患者曾接种过1~3针疫苗,66例(88.0%)患者行初步流行病学调查后有明确的接触史,而34例(91.9%)原始毒株感染患者有明确接触史。5例Delta毒株感染患者无临床症状,54例(72.0%)有不同程度的发热,39例(52.0%)有咳嗽、咽痛、鼻塞、流涕等呼吸道症状,21例(28.0%)有神经系统症状。就诊时病程>48 h患者年龄大于病程 < 24 h患者,差异有统计学意义(P < 0.05)。病程>48 h患者单核细胞计数低于病程 < 24 h患者,病程>48 h患者血小板计数低于病程 < 24 h及24~48 h患者,差异均有统计学意义(P < 0.05)。就诊时病程24~48 h以及>48 h患者胸部CT特征性炎症检出率高于病程 < 24 h患者,差异有统计学意义(P < 0.05)。不同病程患者咽拭子核酸开放阅读框基因、核壳蛋白基因Ct值无差异。
      结论  扬州市Delta毒株COVID-19患者以中老年人为主,首发症状多为发热及呼吸道症状。与COVID-19原始毒株相比,Delta毒株感染患者神经系统症状高发,肺部病灶进展迅速,建议早期诊治。

     

    Abstract:
      Objective  To analyze the epidemiological features, clinical characteristics and auxiliary examination results of patients diagnosed as Delta strain of Coronavirus Disease 2019 (COVID-19).
      Methods  A total of 75 patients diagnosed as Delta strain of COVID-19 from July 29 to August 16 in 2021 in the fever clinic of Subei People's Hospital of Yangzhou City were included, and they were compared with 37 patients diagnosed as original strain of COVID-19 in February 2020 in Yangzhou City in aspects of epidemiological features, clinical characteristics and auxiliary examination results.
      Results  Among 75 patients infected with Delta strain of COVID-19, there were 26 males and 49 females, with a median age of 50.7(35.0, 67.0) years, including 24 cases (32.0%) aged 41 to 64 years old and 28 cases (37.3%) aged ≥ 65 years old. The median age of patients with the original strain was 46.2(36.5, 55.5) years, among whom 20 cases (54.1%) were 41 to 64 years old. Totally 47 patients (62.7%) diagnosed as Delta strain of COVID-19 had received 1 to 3 doses of vaccine, and 66 patients (88.0%) had a clear contact history after preliminary epidemiological investigation. Totally 34 patients (91.9%) with original strain had a clear contact history. Five patients infected with Delta strain had no clinical symptoms, 54 cases (72.0%) had fever in varying degrees, 39 cases (52.0%) had respiratory symptoms such as cough, sore throat, nasal congestion and runny nose, and 21 cases (28.0%) had neurological symptoms. The age of patients with course of disease at visit >48 h was significantly higher than that of patients with course of disease < 24 h (P < 0.05). The monocyte count of patients with course of disease >48 h was significantly lower than that of patients with course of disease < 24 h, and the platelet count of patients with course of disease >48 h was significantly lower than that of patients with course of disease < 24 h and from 24 to 48 h (P < 0.05). The detection rate of chest CT characteristic inflammation in patients with course of disease from 24 to 48 h and >48 h was significantly higher than that in patients with course of disease < 24 h (P < 0.05). There was no difference in the CT values of open reading frame gene and nucleocapsid protein gene in nucleic acid detection of pharyngeal swab in patients with different course of disease.
      Conclusion  The patients infected with Delta strain of COVID-19 in Yangzhou City are mainly middle-aged and elderly people, and the primary symptoms are mostly fever and respiratory symptoms. Compared with the original strain of COVID-19, patients infected with Delta strain have high incidence of neurological symptoms and rapid progress of pulmonary lesions, and early diagnosis and treatment are recommended.

     

/

返回文章
返回