| 摘要: |
| 目的 分析严重急性呼吸综合征冠状病毒2（SARS-CoV-2）奥密克戎BA.2变异株感染者不同部位样本的核酸阴转时间及其影响因素。方法 采用实时荧光PCR序贯检测海军军医大学（第二军医大学）第一附属医院217例确诊为新型冠状病毒肺炎（COVID-19）且基因测序确认病毒株为奥密克戎BA.2变异株患者的鼻咽拭子、痰液和肛拭子SARS-CoV-2核酸，比较不同部位样本核酸阴转时间。采用分层分析及多元线性回归分析法探讨不同部位样本核酸阴转时间的影响因素。结果 217例COVID-19确诊患者的年龄为32.0（24.0，50.5）岁，男128例（59.0%）、女89例（41.0%）；无症状感染者8例（3.7%）、轻型184例（84.8%）、普通型21例（9.7%）、重型3例（1.4%）、危重型1例（0.5%）；接受莫努匹韦抗病毒治疗者70例（32.3%）。鼻咽拭子、痰液和肛拭子的SARS-CoV-2核酸阴转时间分别是13.0（11.0，17.0）、16.5（13.0，21.0）、10.0（5.3，11.0）d，两两比较差异均有统计学意义（P均<0.001）。年龄≥60岁、合并基础疾病尤其是高血压、冠状动脉疾病或神经系统疾病、临床分型为普通型是鼻咽拭子标本核酸阴转时间延长的危险因素；男性、合并基础疾病是痰液标本核酸阴转时间延长的危险因素；男性是肛拭子标本核酸阴转时间延长的危险因素。多元线性回归分析显示，临床分型为危重型是鼻咽拭子SARS-CoV-2核酸阴转时间延长的独立危险因素（P<0.05），男性和合并基础疾病是痰液核酸阴转时间延长的独立危险因素（P均<0.05）。结论 在奥密克戎BA.2变异株感染患者中，痰液标本核酸阳性持续时间最长、肛拭子最短；男性、合并基础疾病患者痰液标本核酸阴转时间较长。 |
| 关键词: 严重急性呼吸综合征冠状病毒2 奥密克戎BA.2变异株 阴转时间 鼻咽拭子 痰液 肛拭子 |
| DOI：10.16781/j.CN31-2187/R.20220692 |
| 投稿时间：2022-08-26修订日期：2022-11-03 |
| 基金项目:海军军医大学（第二军医大学）第一附属医院新型冠状病毒感染科研攻关项目（COVID-ZD-011）. |
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| Viral shedding time and its influencing factors in different site samples of patients infected with severe acute respiratory syndrome coronavirus 2 omicron BA.2 variant |
| GE Ling-ling,DONG Xu,WANG Xin-yu,XU Ming-xiao,GUO Hong-lei,LIU Ya-yun,XU Ai-jing,FAN Wen-han,LIANG Xue-song* |
(Department of Infectious Diseases, The First Affiliated Hospital of Naval Medical University (Second Military Medical University), Shanghai 200433, China
*Corresponding author) |
| Abstract: |
| Objective To analyze the viral shedding time and its influencing factors in different site samples of patients infected with severe acute respiratory syndrome coronavirus 2 (SARA-CoV-2) omicron BA.2 variant. Methods Real-time fluorescence polymerase chain reaction was used to detect SARS-CoV-2 nucleic acid in nasopharyngeal swab, sputum and anal swab from 217 patients with coronavirus disease 2019 (COVID-19) who were infected with severe acute respiratory syndrome coronavirus 2 omicron BA.2 variant confirmed by gene sequencing in The First Affiliated Hospital of Naval Medical University (Second Military Medical University). The differences of viral shedding time of different site samples were compared. Stratified analysis and multiple linear regression analysis were used to explore the influencing factors of viral shedding time in different site samples. Results The age of the 217 COVID-19 patients was 32.0 (24.0, 50.5) years old, 59.0% of them were males (n=128), and 41.0% were females (n=89). Eight (3.7%) cases were diagnosed with asymptomatic infection, 184 (84.8%) cases were mild type, 21 (9.7%) cases were moderate type, 3 (1.4%) cases were severe type, and 1 (0.5%) case was critical type. A total of 70 (32.3%) patients were treated with molnupiravir. The viral shedding time of SARS-CoV-2 nucleic acid in nasopharyngeal swab, sputum and anal swab was 13.0 (11.0, 17.0) d, 16.5 (13.0, 21.0) d and 10.0 (5.3, 11.0) d, respectively, with the differences being significant between them (all P<0.001). Age ≥ 60 years old, underlying diseases (especially hypertension, coronary artery diseases, or neurological diseases), and clinical classification of moderate type were risk factors for prolonged viral shedding time in nasopharyngeal swab; male sex and underlying diseases were risk factors for prolonged viral shedding time in sputum; and male sex was a risk factor for prolonged viral shedding time in anal swab. Multiple linear regression analysis showed that critical type was an independent risk factor for prolonged viral shedding time in nasopharyngeal swab (P<0.05), and male sex and underlying diseases were independent risk factors for prolonged viral shedding time in sputum (both P<0.05). Conclusion Among patients infected with omicron BA.2 variant, the viral shedding time in sputum is the longest and that in anal swab is the shortest. Male patients and/or patients with underlying diseases have longer viral shedding time in sputum. |
| Key words: severe acute respiratory syndrome coronavirus 2 omicron BA.2 variant shedding time nasopharyngeal swab sputum anal swab |
