新型冠状病毒肺炎相关急性呼吸道感染及就诊情况调查

目的了解我国新型冠状病毒肺炎(新冠肺炎)流行期间,人群急性呼吸道感染(ARI)的患病和就诊情况。方法根据截至2020年3月31日各省(市)新冠肺炎病例累计报告发病率,将各省(市)划分为高、中、低流行地区,采用分层两阶段整群随机抽样方法抽取社区人群进行面对面问卷调查。收集新冠肺炎流行期间社区人群新冠肺炎相关ARI的患病和就诊资料,计算新冠肺炎相关ARI罹患率和就诊比例,采用非条件logistic回归分析社区人群新冠肺炎相关ARI患病和就诊的影响因素。结果共调查34857名社区居民,647名(1.9%)调查对象自报在新冠肺炎流行期间出现过新冠肺炎相关ARI,其中241名(37.2%)患者曾前往医疗机构就诊。从新冠肺炎相关ARI患病情况来看,在高流行地区,罹患新冠肺炎相关ARI的风险是低流行地区的1.36倍(95%CI:1.12~1.65);在不同年龄组中,20~39岁、≥60岁组罹患新冠肺炎相关ARI的风险分别是1~9岁组的1.80倍(95%CI:1.29~2.59)、1.63倍(95%CI:1.14~2.40);有基础疾病史罹患新冠肺炎相关ARI的风险是无基础疾病史的1.53倍(95%CI:1.23~1.89);有新冠肺炎确诊病例、发热或呼吸道症状者接触史的人群罹患新冠肺炎相关ARI的风险分别是无接触史的1.53倍(95%CI:1.01~2.27)、6.60倍(95%CI:5.05~8.53)。有发热或呼吸道症状者接触史的新冠肺炎相关ARI患者就诊的比例是无接触史的1.68倍(95%CI:1.05~2.70)。结论新冠肺炎相关ARI的罹患率受该地区的新冠肺炎流行水平高低的影响,新冠肺炎高流行地区新冠肺炎相关ARI罹患率也高。然而我国新冠肺炎相关ARI患者发病后就诊的比例较低。因此,在新冠疫情流行期间,应加强卫生服务利用宣传,积极提高人群ARI等疾病的就诊意识。

Investigation of incidence of acute respiratory infection and healthcare-seeking behavior in period of COVID-19 epidemic

Objective To analyze the incidence of acute respiratory infection(ARI)and related healthcare seeking behaviors in population in the period of COVID-19 epidemic in China.Methods According to the province specific cumulative incidence rates of COVID-19 reported as of March 31,2020,the low,medium and high-risk areas were classified.In these areas,a stratified two stage cluster random sampling method was used to select participants for face-to-face questionnaire surveys.Data on the incidence of ARI and related healthcare seeking behaviors in community residents during COVID-19 epidemic period were collected to calculate the attack rate of ARI and related healthcare seeking rate.Logistic regression method was used to explore the influencing factors for ARI incidence and healthcare seeking behavior.Results A total of 34857 community residents were surveyed,in whom 647(1.9%)reported that they had ARI symptoms during the COVID-19 epidemic period,and 241(37.2%)had healthcare seeking behaviors.In terms of the incidence of COVID-19-related ARI,in high-risk area,the risk of COVID-19-related ARI was 1.36 times(95%CI:1.12-1.65)than that in low-risk area;among different age groups,the risk of COVID-19-related ARI in age groups 20-39 years,≥60 years was 1.80 times(95%CI:1.29-2.59)and 1.63 times(95%CI:1.14-2.40)than that in age group 1-9 years;the risk of COVID-19-related ARI in people with underlying diseases was 1.53 times(95%CI:1.23-1.89)than that in those without underlying diseases;the risk of COVID-19-related ARI in people with contacts with confirmed cases of COVID-19 and people with fever or respiratory symptoms was 1.53 times(95%CI:1.01-2.27)and 6.60 times(95%CI:5.05-8.53)than those in people without these contacts.The healthcare seeking rate in COVID-19-related ARI patients with exposures to those with fever or respiratory symptoms was 1.68 times(95%CI:1.05-2.70)than that in such patients without the exposures.Conclusions The attack rate of COVID-19-related ARI was affected by the local epidemic level of COVID-19,and in high-risk area,the attack rate of COVID-19-related ARI was also high.The healthcare seeking rate in patients with COVID-19-related ARI was low.Therefore,it is necessary to encourage the healthcare seeking in people with ARI in COVID-19 pandemic period.