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接种灭活疫苗后的境外输入性新冠肺炎患者临床特征
引用本文:陈沐,周圆明,彭辉,巫培连,莫晓能.接种灭活疫苗后的境外输入性新冠肺炎患者临床特征[J].中国感染控制杂志,2021,20(7):586-591.
作者姓名:陈沐  周圆明  彭辉  巫培连  莫晓能
作者单位:广州医科大学附属市八医院呼吸内科, 广东 广州 510060
摘    要: 目的 通过比较接种/未接种新型冠状病毒灭活疫苗(Vero细胞)后感染新型冠状病毒(COVID-19)的境外输入性患者的临床特征,为临床诊疗提供参考。方法 选取2021年1月4日—4月10日广州医科大学附属市八医院收治的接种灭活疫苗后境外输入性COVID-19患者(接种疫苗组),及同期来自相同输入国家的未接种新冠疫苗的确诊COVID-19患者(未接种疫苗组)为研究对象,通过比较两组患者的人口学特征、临床症状、血液检查结果及抗体、胸部影像学、治疗方法及预后等,分析总结接种灭活疫苗后境外输入性COVID-19患者的临床特征。结果 接种疫苗组、未接种疫苗组分别纳入38例患者,患者的平均年龄分别为(37.14±8.86)岁、(39.21±7.66)岁;男性58例,女性18例。两组患者的临床症状中,除了未接种疫苗组患者出现咽喉不适比率高于接种疫苗组(34.21% VS 13.16%,P<0.05),其余临床症状两组间比较,差异无统计学意义(P>0.05)。两组患者血白细胞、淋巴细胞、肝肾功能、心肌酶学、氧合指标、D-二聚体等指标比较,差异均无统计学意义(P>0.05);两组患者病程中出现炎症指标升高的比例、T淋巴细胞CD4+、CD8+下降的比例比较,差异均无统计学意义(P>0.05)。在病程前2周内,接种疫苗组患者新型冠状病毒抗体IgG阳性比例均高于未接种疫苗组,差异有统计学意义(P<0.05)。两组患者的肺部影像学情况比较,差异无统计学意义(P>0.05)。结论 接种灭活新冠疫苗(Vero细胞)后境外输入性COVID-19患者以青中年男性为主,临床分型以核酸检测阳性及普通型患者居多,所有患者经治疗后均预后良好。接种灭活疫苗(Vero细胞)后再感染新型冠状病毒患者较未接种疫苗的患者,在病程早期(1周内)即迅速产生IgG抗体,但核酸转阴时间较长。

关 键 词:灭活疫苗  Vero细胞  新型冠状病毒肺炎  境外输入性  临床特征  
收稿时间:2021/4/21 0:00:00

Clinical characteristics of imported COVID-19 patients after inoculating inactivated vaccine
Mu CHEN,Yuan-ming ZHOU,Hui PENG,Pei-lian WU,Xiao-neng MO.Clinical characteristics of imported COVID-19 patients after inoculating inactivated vaccine[J].Chinese Journal of Infection Control,2021,20(7):586-591.
Authors:Mu CHEN  Yuan-ming ZHOU  Hui PENG  Pei-lian WU  Xiao-neng MO
Institution:Departments of Respiratory Diseases, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou 510060, China
Abstract:Objective To compare clinical characteristics of imported coronavirus disease 2019 (COVID-19) patients after inoculated/non-inoculated inactivated vaccine (Vero cells) for SARS-CoV-2, provide reference for clinical diagnosis and treatment. Methods Imported COVID-19 patients who had inoculated inactivated vaccine (vaccinated group) and COVID-19 patients from the same countries but didn''t inoculate vaccine (non-vaccinated group) who were admitted in Guangzhou Eighth People''s Hospital, Guangzhou Medical University from January 4 to April 10, 2021 were chosen. Through comparing the demographic characteristics, clinical symptoms, blood test results and antibodies, chest imaging, as well as treatment methods and prognosis of two groups of patients, clinical chara-cteristics of imported COVID-19 patients after inoculated inactivated vaccine were analyzed and summarized. Results 38 patients in vaccinated group and 38 in non-vaccinated group were included in analysis, the average age of patients was (37.14±8.86) and (39.21±7.66) years old respectively; 58 were males and 18 were females. In the clinical symptoms of two groups, except throat discomfort rate of non-vaccinated group was higher than that of vaccinated group (34.21% vs 13.16%, P < 0.05), there was no significant difference in other clinical symptoms between two groups (P>0.05). There were no significant differences in white blood cells, lymphocytes, liver and kidney function, myocardial enzyme, oxygenation index and D-2 polymer between two groups of patients (P>0.05); there were also no significant differences in the increased proportion of inflammation markers as well as decreased proportion of T lymphocytes CD4+ and CD8+ between two groups of patients (P>0.05). Within 2 weeks before disease course, positive rate of SARS-CoV-2 antibody IgG in vaccinated group was higher than that in non-vaccinated group, difference was statistically significant (P < 0.05). There was no significant difference in lung imaging between two groups of patients (P>0.05). Conclusion Imported COVID-19 patients after inoculating inactivated vaccine (Vero cells) are mainly young and middle-aged men, most clinical types are nucleic acid test positive and common type, all patients had a good prognosis after treatment. Compared with patients without inoculating inactivated vaccine, patients infected SARS-CoV-2 after inoculating vaccine can produce IgG antibody rapidly in the early stage of disease (within one week), but nucleic acid turns negative for a long time.
Keywords:inactivated vaccine  Vero cell  COVID-19  import  clinical characteristic
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