珠海市2019新型冠状病毒奥密克戎变异株感染者的临床特征分析

目的探讨珠海市2019新型冠状病毒(2019 novel coronavirus, 2019-nCoV)奥密克戎变异株感染者的临床特征。方法回顾性分析2022年1月13日至25日中山大学附属第五医院收治的39例2019-nCoV奥密克戎变异株感染者(奥密克戎变异株组), 以及2020年1月17日至2月17日收治的98例2019-nCoV非奥密克戎变异株感染者(非奥密克戎变异株组), 分别比较2组成人和儿童感染者的临床特征。统计学方法采用曼-惠特尼U检验、χ2检验和Fisher确切概率法。结果 21例奥密克戎变异株组成人患者的年龄为34.0(26.0, 40.5)岁, 小于93例非奥密克戎变异株组成人患者[50.0(36.0, 62.0)岁, Z=-3.81, P<0.001], 有基础疾病患者的比例小于非奥密克戎变异株组[4.8%(1/21)比31.2%(29/93), χ2=6.17, P=0.013];奥密克戎变异株组的临床分型为轻型[71.4%(15/21)]或普通型[28.6%(6/21)], 而非奥密克戎变异株组以普通型[57.0%(53/93)]和重型[23.7%(2...     

2019新型冠状病毒奥密克戎变异株感染者38例的临床特征分析

目的分析2019新型冠状病毒奥密克戎变异株感染者的临床特征,为奥密克戎变异株的防控提供参考。方法纳入2021年12月23日至2022年1月31日深圳市第三人民医院收治的38例2019新型冠状病毒奥密克戎变异株感染者,回顾性分析患者的流行病学资料、临床表现、新型冠状病毒疫苗接种和实验室检查情况。采集鼻咽拭子样本进行病毒核酸检测,采用实时荧光聚合酶链反应扩增2019新型冠状病毒的开放阅读框(open reading frame,ORF)1ab基因和N基因。采集血液样本检测2019新型冠状病毒IgM和IgG抗体水平。结果38例患者中输入性病例35例(92.1%),其中美国输入20例(57.1%)。36例(94.7%)患者接种过新型冠状病毒疫苗,其中末次接种后≤1个月发病者占5.7%(2/35),>3个月发病者占65.7%(23/35)。3例为无症状感染者。35例确诊患者中,咳嗽31例(88.6%),咽痛14例(40.0%),发热13例(37.1%),鼻塞10例(28.6%),流涕8例(22.9%);入院时白细胞计数正常者33例(94.3%),降低者1例(2.9%);淋巴细胞计数减少者19例(54.3%);C反应蛋白升高者18例(51.4%);白细胞介素6水平升高者35例(100.0%);降钙素原升高者10例(28.6%);D-二聚体升高者6例(17.1%);ALT升高者1例(2.9%);血钾降低者10例(28.6%)。ORF1ab基因循环阈值(Ct值)为22.15±6.00,最低值为14.22,N基因循环阈值为21.86±5.72,最低值为13.04。2019新型冠状病毒IgM抗体水平为0.46(0.21,1.12)AU/mL;IgG抗体水平为126.55(8.31,289.85)AU/mL,其中20例患者IgG抗体>100 AU/mL,12例IgG抗体>200 AU/mL,最高达414.48 AU/mL。结论目前奥密克戎变异株感染者的主要临床表现为咳嗽、咽痛、发热、鼻塞,接种新型冠状病毒疫苗后仍有可能感染奥密克戎变异株,且病毒核酸水平较高,需注意防护。     

肾移植受者新型冠状病毒奥密克戎变异株感染临床特征分析

［摘要］　目的　探讨肾移植受者感染新型冠状病毒（SARS-CoV-2）奥密克戎（Omicron）变异株的临床特征,分析新型冠状病毒感染(COVID-19)和病毒转阴时间的影响因素。方法　回顾性分析2022年12月至2023年2月在山西省第二人民医院肾移植中心随访的肾移植受者SARS-CoV-2 Omicron变异株的感染情况,以网络问卷方式进行问卷填写,对感染者年龄、性别、吸烟、共病情况（合并慢性病）、肾移植术后时间、病毒转阴时间、新型冠状病毒疫苗（简称“新冠疫苗”）接种、免疫抑制方案、服用熊去氧胆酸及SARS-CoV-2抗体产生等情况进行调查,并分析新冠疫苗接种情况和病毒转阴时间的影响因素。结果　628例肾移植受者参加调查问卷,其中感染组476例,非感染组152例。感染组男女比例为1.9∶1,以轻型为主;合并1种及以上慢性病者占75.21%,以高血压、糖尿病为主。非/部分接种组和完全/增强接种组分别为300例和328例。在感染时距离末次疫苗接种的时间>6个月者占82.59%（166/201）;200例肾移植受者感染后行SARS-CoV-2抗体检测,感染至抗体检测中位时间为47 d,IgG阳性或弱阳性者占48.50%（97/200）。病毒转阴时间与免疫抑制方案相关,含霉酚酸(MPA)类药物的免疫抑制方案病毒转阴时间较含咪唑立宾（MZR）方案长。感染组和非感染组在年龄、性别、肾移植术后时间、共病及新冠疫苗接种方面比较差异无统计学意义（P>0.05）。新冠疫苗接种情况与性别及肾移植术后时间有关。结论　肾移植受者在各年龄段及术后不同时期对于SARS-CoV-2 Omicron变异株普遍易感,以轻型为主。感染后普遍产生SARS-CoV-2 IgG抗体。服用含MZR的免疫抑制方案较含MPA类药物方案感染后病毒转阴时间短。接种新冠疫苗有一定的保护作用,男性及肾移植术后时间较长的肾移植受者疫苗接种率高。     

上海某方舱医院新型冠状病毒奥密克戎变异株感染者流行病学特征分析

[摘要]　目的　探讨上海某方舱医院新型冠状病毒奥密克戎变异株感染者的发病情况及流行病学特征。方法　以2022年4月9日—5月5日上海国家会展中心方舱医院收治的新型冠状病毒奥密克戎变异株感染者为研究对象,对感染者年龄、性别、地区、疫苗接种等疫情数据进行流行病学特征分析。结果　122 151例新型冠状病毒感染者均为奥密克戎变异株BA.2或BA.2.2亚型感染,其流行病学特征结果显示：患者男女比例为1.51:1;平均年龄为（44.91±15.38）岁;0～17岁、18～30岁、31～60岁和≥61岁感染者分别占4.74%、20.80%、62.52%和11.94%;无症状感染者占80.80%,轻型患者占19.20%;平均住院时间为（7.00±2.77）d;未接种和完成1、2和3次疫苗接种的感染者分别占20.30%、3.18%、31.30%和45.22%,其中≥61岁且完成3次疫苗接种的感染者仅占10.10%。结论　各个年龄段人群对于新型冠状病毒奥密克戎变异株普遍易感。无症状感染者是本次疫情的主体人群,临床症状不典型,早期隐匿传播,积极加强核酸检测是早期发现疫情的必要手段。     

新型冠状病毒奥密克戎变异株感染轻型患者的中医证候特点

目的 ：分析本土新型冠状病毒（新冠）变异株感染轻型患者的中医证候特点,为该病的防治提供临床依据。方法：选取2022年3月24日—4月24日上海交通大学医学院附属瑞金医院北部院区以及嘉荷新苑方舱收治的感染新冠奥密克戎变异株轻型患者为研究对象,共计纳入188例。通过问卷星进行基本情况、疾病史、流行病学史、中医证候和转阴天数等的收集,分析患者的一般情况、舌苔脉象辨证分型,及不同证型转阴时间。结果：轻型患者基础体质均较好,合并各种基础疾病的比例均低于20%。根据舌象、舌形、舌苔观察,发现不同舌形转阴中位时间差异有统计学意义（P<0.01）。寒湿郁肺证占38.8%,邪热犯肺证占34.5%,湿遏肺卫证占23.4%,其中寒湿郁肺证及邪热犯肺证为感染奥密克戎变异株轻型患者的主要证型。各证型转阴中位天数差异无统计学意义（P>0.05）。结论：上海本土感染新冠奥密克戎变异株发病以疫毒兼挟寒湿之邪致病为主,其中寒湿郁肺证最多见。     

2019新型冠状病毒奥密克戎变异株感染者的临床特征分析

目的探讨2019新型冠状病毒奥密克戎变异株感染患者的临床特征及预后因素。方法纳入2021年7月1日至2022年1月6日上海市(复旦大学附属)公共卫生临床中心收治的987例境外输入新型冠状病毒肺炎(COVID-19)确诊患者, 根据2019新型冠状病毒核酸检测结果分为奥密克戎组(193例)与非奥密克戎组(794例), 收集两组患者的临床资料、影像学检查和实验室检查结果进行比较。统计学方法采用χ2检验和曼-惠特尼U检验, 采用多重线性回归分析进行多因素分析。结果奥密克戎组以18～30岁者居多, 占51.3%(99/193), 高于非奥密克戎组的31.4%(249/794), 差异有统计学意义(χ2=52.75, P<0.001)。奥密克戎组中轻型占88.6%(171/193), 高于非奥密克戎组中的81.6%(648/794),差异有统计学意义(χ2=5.37, P=0.021)。奥密克戎组患者临床表现较非奥密克戎组更多见[60.1%(116/193)比29.1%(231/794)], 差异有统计学意义(χ2=65.49, P<0.001), 以咽痛/咽痒、发热、咳嗽/咳痰为主...     

385例新型冠状病毒奥密克戎变异株核酸检测阳性住院患者临床特征分析

目的 分析新型冠状病毒奥密克戎变异株核酸检测阳性住院病例特征。方法 收集385名在我院住院(非重症、危重)新型冠状病毒奥密克戎变异株核酸检测阳性患者的临床资料,分析其临床特征。结果 385名患者中,年龄≥60岁患者占71.4%;行Pearson相关性研究,提示年龄、合并基础疾病个数与患者的疫苗接种次数呈负相关性(r=-0.70、-0.57;P<0.01、<0.01);通过二元Logistic回归分析,发现高龄、伴发心衰、肺部慢性疾病、血糖控制差、神经系统疾病导致行动不便、营养状态差、肾功能差、合并肿瘤,均是导致患者基础疾病危重的危险因素(χ²=101.82,P<0.01)。结论 本轮疫情,住院(非重症、危重)新型冠状病毒奥密克戎变异株核酸检测阳性患者,以老年人为主;患者年龄越大、合并基础疾病越多,接种新冠疫苗率越低;高龄、伴发心衰、肺部慢性疾病、血糖控制差、神经系统疾病导致行动不便、营养状态差、肾功能差、合并肿瘤均是导致患者被最终判定为基础疾病危重的危险因素,对于这类患者一旦感染新冠,建议早干预治疗。     

新型冠状病毒奥密克戎变异株BA.5、BA.2亚型感染成人和儿童临床特征的分析题录

目的了解和比较上海市儿童和成人感染新型冠状病毒奥密克戎变异株BA.5、BA.2亚型的临床特征。方法收集2022年12月1日至2023年1月20日奥密克戎变异株BA.5亚型主导流行期复旦大学附属儿科医院收治的524例新型冠状病毒感染住院儿童的临床资料, 包括年龄、性别、临床症状、实验室检查结果等, 并对同期家庭内密切接触者临床资料进行收集, 与2022年4月4日至4月30日奥密克戎变异株BA.2亚型主导流行期复旦大学附属儿科医院收治的新型冠状病毒感染住院儿童和家庭内感染者临床特征进行比较;对BA.5亚型感染的儿童与成人、危重型与非危重型病例的临床资料进行比较。统计学分析采用独立样本t检验、曼-惠特尼U检验、χ2检验或Fisher确切概率法。结果 524例患儿的年龄范围为5 d至16岁, 其中男301例(57.4%), 女223例(42.6%), 危重型29例(5.5%), 非危重型495例(94.5%)。危重型患儿的发热热峰、气促发生率、肺炎发生率、基础疾病发生率均高于非危重型患儿, 差异均有统计学意义(t=12.06,χ2=34.90、10.04、31.10, 均P<0.05);实验室检查方面, 危重型患儿淋巴细胞计数减少发生率, C反应蛋白, 降钙素原, 白细胞介素-6, 肝功能、肾功能、肌酸激酶同工酶异常比例均高于非危重型患儿, 差异均有统计学意义(χ2=8.18, Z=-4.61, Z=-4.28, Z=-5.13, χ2=195.90, Fisher确切概率法, χ2=136.13, 均P<0.05)。非危重型BA.5亚型感染者中, 儿童组症状感染比例高于成人组, 儿童组发热、胃肠道症状(恶心、呕吐、腹泻)发生率高于成人组, 而成人组咳嗽发生率高于儿童组, 差异均有统计学意义(χ2=11.16、11.83、8.50、28.14, 均P<0.05)。2022年12月1日至2023年1月20日和2022年4月4日至4月30日分别收集到588例和355例儿童病例、791例和755例成人病例。儿童组中, BA.5亚型感染患儿咳嗽、惊厥、危重病例发生率较BA.2亚型感染患儿高, 差异均有统计学意义(χ2=37.95、40.78、15.54, 均P<0.001)。成人组中, BA.5亚型感染者发热热峰、热程、发热发生率、咳嗽发生率、胃肠道症状发生率均高于BA.2亚型感染者, 差异均有统计学意义(t=-4.40,Z=-9.64,χ2=47.29、124.09、29.90, 均P<0.001)。结论上海地区奥密克戎变异株BA.5亚型流行高峰时期, 危重型患儿全身症状重, 合并基础疾病发生率高于非危重型患儿。非危重型BA.5亚型感染者中, 儿童症状感染比例高于成人, 发热及胃肠道症状较成人多见, 而成人咳嗽症状发生率高于儿童。BA.5亚型感染患儿惊厥、危重病例发生率较BA.2亚型高, BA.5亚型感染成人患者的全身症状较BA.2亚型重。     

新型冠状病毒奥密克戎变异株的研究进展:对其科学防控措施的启示

新型冠状病毒肺炎的大流行仍然是全球公共卫生系统的巨大威胁.截至2022年1月11日16点52分,过去24h内全球新增1738701例感染病例和5150例死亡病例.最近,新型冠状病毒在全球范围内出现了多种变异株,特别是B.1.1.529变异株奥密克戎(Omicron),该变异株在其刺突蛋白中含有大量的突变,这些突变的位置...     

新型冠状病毒奥密克戎变异株感染对儿童活体肝移植早期恢复的影响

［摘要］　目的　探讨新型冠状病毒奥密克戎变异株感染对儿童活体肝移植早期恢复的影响。方法　回顾性分析2022年12月至2023年2月天津市第一中心医院器官移植中心儿童器官移植科完成的19例儿童肝移植病例资料。根据术前1个月内新型冠状病毒感染（COVID-19）核酸检测结果将患儿分为阳性组（8例）和阴性组（11例）。对两组基线资料以及术后早期血常规、肝功能、FK506血药浓度等资料进行分析。结果　阳性组和阴性组的性别、年龄、体重、小儿终末期肝病模型（PELD）评分差异无统计学意义（P>0.05）。两组移植物重量、移植物与受者质量比（GRWR）、供肝冷缺血时间、无肝期、术后呼吸机支持时间、住ICU时间、术后住院时间等差异无统计学意义（P>0.05）。两组术后2周内血常规及肝功能变化趋势差异无统计学意义（P>0.05）。两组受者术后均无COVID-19发生,呼吸道症状、急性排斥反应及FK506血药浓度差异无统计学意义（P>0.05）。结论　新型冠状病毒奥密克戎变异株轻症感染对儿童活体肝移植受者早期恢复无明显影响。     

Impact of the Omicron variant on SARS-CoV-2 reinfections in France,March 2021 to February 2022

Since the first reports in summer 2020, SARS-CoV-2 reinfections have raised concerns about the immunogenicity of the virus, which will affect SARS-CoV-2 epidemiology and possibly the burden of COVID-19 on our societies in the future. This study provides data on the frequency and characteristics of possible reinfections, using the French national COVID-19 testing database. The Omicron variant had a large impact on the frequency of possible reinfections in France, which represented 3.8% of all confirmed COVID-19 cases since December 2021.     

Shorter serial intervals in SARS-CoV-2 cases with Omicron BA.1 variant compared with Delta variant,the Netherlands, 13 to 26 December 2021

The SARS-CoV-2 Omicron variant has a growth advantage over the Delta variant because of higher transmissibility, immune evasion or shorter serial interval. Using S gene target failure (SGTF) as indication for Omicron BA.1, we identified 908 SGTF and 1,621 non-SGTF serial intervals in the same period. Within households, the mean serial interval for SGTF cases was 0.2–0.6 days shorter than for non-SGTF cases. This suggests that the growth advantage of Omicron is partly due to a shorter serial interval.     

Outbreak caused by the SARS-CoV-2 Omicron variant in Norway,November to December 2021

In late November 2021, an outbreak of Omicron SARS-CoV-2 following a Christmas party with 117 attendees was detected in Oslo, Norway. We observed an attack rate of 74% and most cases developed symptoms. As at 13 December, none have been hospitalised. Most participants were 30–50 years old. Ninety-six percent of them were fully vaccinated. These findings corroborate reports that the Omicron variant may be more transmissible, and that vaccination may be less effective in preventing infection compared with Delta.     

Risk reduction of hospitalisation and severe disease in vaccinated COVID-19 cases during the SARS-CoV-2 variant Omicron BA.1-predominant period,Navarre, Spain,January to March 2022

BackgroundAs COVID-19 vaccine effectiveness against SARS-CoV-2 infection was lower for cases of the Omicron vs the Delta variant, understanding the effect of vaccination in reducing risk of hospitalisation and severe disease among COVID-19 cases is crucial.AimTo evaluate risk reduction of hospitalisation and severe disease in vaccinated COVID-19 cases during the Omicron BA.1-predominant period in Navarre, Spain.MethodsA case-to-case comparison included COVID-19 epidemiological surveillance data in adults ≥ 18 years from 3 January–20 March 2022. COVID-19 vaccination status was compared between hospitalised and non-hospitalised cases, and between severe (intensive care unit admission or death) and non-severe cases using logistic regression models.ResultsAmong 58,952 COVID-19 cases, 565 (1.0%) were hospitalised and 156 (0.3%) were severe. The risk of hospitalisation was reduced within the first 6 months after full COVID-19 vaccination (complete primary series) (adjusted odds ratio (aOR): 0.06; 95% CI: 0.04–0.09) and after 6 months (aOR: 0.16; 95% CI: 0.12–0.21; p_comparison < 0.001), as well as after a booster dose (aOR: 0.06: 95% CI: 0.04–0.07). Similarly, the risk of severe disease was reduced (aOR: 0.13, 0.18, and 0.06, respectively). Compared with cases fully vaccinated 6 months or more before a positive test, those who had received a booster dose had lower risk of hospitalisation (aOR: 0.38; 95% CI: 0.28–0.52) and severe disease (aOR: 0.38; 95% CI: 0.21–0.68).ConclusionsFull COVID-19 vaccination greatly reduced the risk of hospitalisation and severe outcomes in COVID-19 cases with the Omicron variant, and a booster dose improved this effect in people aged over 65 years.     

Molecular epidemiology of the SARS-CoV-2 variant Omicron BA.2 sub-lineage in Denmark, 29 November 2021 to 2 January 2022

Following emergence of the SARS-CoV-2 variant Omicron in November 2021, the dominant BA.1 sub-lineage was replaced by the BA.2 sub-lineage in Denmark. We analysed the first 2,623 BA.2 cases from 29 November 2021 to 2 January 2022. No epidemiological or clinical differences were found between individuals infected with BA.1 versus BA.2. Phylogenetic analyses showed a geographic east-to-west transmission of BA.2 from the Capital Region with clusters expanding after the Christmas holidays. Mutational analysis shows distinct differences between BA.1 and BA.2.     

SARS-CoV-2 Omicron Variant,Lineage BA.1, Is Associated with Lower Viral Load in Nasopharyngeal Samples Compared to Delta Variant

Objectives: High viral load in upper respiratory tract specimens observed for Delta cases might contribute to its increased infectivity compared to the other variant. However, it is not yet documented if the Omicron variant’s enhanced infectivity is also related to a higher viral load. Our aim was to determine if the Omicron variant’s spread is also related to higher viral loads compared to the Delta variant. Methods: Nasopharyngeal swabs, 129 (Omicron) and 85 (Delta), from Health Care Workers were collected during December 2021 at the University Hospital of Lyon, France. Cycle threshold (Ct) for the RdRp target of cobas^® 6800 SARS-CoV-2 assay was used as a proxy to evaluate SARS-CoV-2 viral load. Variant identification was performed using a screening panel and confirmed by whole genome sequencing. Results: Herein, we showed that the RT-PCR Ct values in Health Care Workers sampled within 5 days after symptom onset were significantly higher for Omicron cases than Delta cases (21.7 for Delta variant and 23.8 for Omicron variant, p = 0.008). This difference was also observed regarding patient with complete vaccination. Conclusions: This result supports the studies showing that the increased transmissibility of Omicron is related to other mechanisms than higher virus excretion.     

Burden of Pediatric SARS-CoV-2 Hospitalizations during the Omicron Wave in Germany

(1) Background: When the Omicron variant of SARS-CoV-2 first emerged in Germany in January 2022, data on related disease severity among children and adolescents were not yet available. Given Omicron’s high transmissibility, the ability to assess its impact on admission and hospitalization rates in children’s hospitals is critical for the purpose of understanding the scope of its burden on the German healthcare system. (2) Methods: From 24 January 2022 to 31 July 2022, SARS-CoV-2 cases admitted to German pediatric hospitals were monitored via a national, clinician-led reporting system (CLRS) established by the German Society for Pediatric Infectious Diseases (DGPI). Cases treated on general wards and intensive care units, as well as patient age and the need for respiratory support, were recorded. (3) Results: From January to July 2022, a median of 1.7 cases (range 0.4–3) per reporting pediatric hospital per day was hospitalized in general wards, whereas a median of 0.1 cases (range 0–0.4 cases) was admitted to intensive care units. Of all hospitalized patients, 4.2% received respiratory support. (4) Conclusions: Despite the high incidence rates documented in connection with the Omicron variant in early 2022, the number of pediatric hospital admissions, and especially the number of cases with the need for intensive care treatment and respiratory support due to symptomatic SARS-CoV-2 infection, remained relatively low. Higher Omicron incidence rates had only a modest impact on SARS-CoV-2-related admissions and hospitalization in German children’s hospitals.     

Effect of Previous COVID-19 Vaccination on Humoral Immunity 3 Months after SARS-CoV-2 Omicron Infection and Booster Effect of a Fourth COVID-19 Vaccination 2 Months after SARS-CoV-2 Omicron Infection

In this study, we aimed to determine the effect of COVID-19 vaccination on 3-month immune response and durability after natural infection by the Omicron variant and to assess the immune response to a fourth dose of COVID-19 vaccination in patients with prior natural infection with the Omicron variant. Overall, 86 patients aged ≥60 years with different vaccination histories and 39 health care workers (HCWs) vaccinated thrice before Omicron infection were enrolled. The sVNT50 titer was significantly lower in patients with incomplete vaccination before SARS-CoV-2 infection with the S clade (p < 0.001), Delta variant (p < 0.001), or Omicron variant (p = 0.003) than in those vaccinated thrice. The sVNT results against the Omicron variant did not differ significantly in patients aged ≥60 years (p = 0.49) and HCWs (p = 0.17), regardless of the recipient receiving the fourth dose 2 months after COVID-19. Incomplete COVID-19 vaccination before Omicron infection for individuals aged ≥60 years conferred limited protection against homologous and heterologous virus strains, whereas two or three doses of the vaccine provided cross-variant humoral immunity against Omicron infection for at least 3 months. However, a fourth dose 2 months after Omicron infection did not enhance immunity against the homologous strain. A future strategy using the bivalent Omicron-containing booster vaccine with appropriate timing will be crucial.