摘要
目的分析新型冠状病毒(SARS-CoV-2)Delta变异株感染病例的临床特征,为Delta感染病例的防治提供参考依据。方法回顾性分析2021年7-8月湖南师范大学附属张家界医院收治的76例SARS-CoV-2变异株Delta感染病例的临床特征。结果本次疫情涉及17个家庭,8个工作环境和场地中的76例感染者,平均年龄为(34.7±18.1)岁,高发于15~49岁人群。无症状感染者4例(5.26%),轻型17例(22.37%),普通型50例(65.79%),重型4例(5.26%),危重型1例(1.32%);76例Delta感染者中SARS-CoV-2核酸最低Ct值N值17.5,Lab值16.25,平均SARS-CoV-2核酸持续阳性时间为34.5 d,其中23例出院7 d后再次出现SARS-CoV-2核酸Ct值阳性。主要临床表现为发热和咳嗽。感染早期98.68%的患者血常规中白细胞计数正常或降低,11.84%患者天门冬氨酸氨基转移酶(AST)/丙氨酸氨基转移酶(ALT)出现轻度升高,少数患者肌酐和心肌酶出现异常;血沉(ESR)、降钙素原(PCT)和C反应蛋白(CRP)升高的比率分别为58.21%、5.26%和31.58%。其中55例(73.37%)出现肺部病变,以沿胸膜下分布的磨玻璃样影改变为主要影像学特点,部分病例合并胸腔积液和实变。结论Delta感染者体内病毒载量高,核酸转阴时间长,主要临床表现为发热、咳嗽,早期可伴AST/ALT升高。
Objective To analyze the clinical characteristics of patients with SARS-CoV-2 Delta variant infection,provide reference for the prevention and treatment of Delta infection.Methods Clinical characteristics of 76 patients with SARS-CoV-2 Delta variant infection in Zhangjiajie Hospital Affiliated to Hunan Normal University from July to August 2021 were analyzed retrospectively.Results The outbreak involved 76 infected persons in 17 families,8 working settings,with an average age of(34.7±18.1)years old,as well as a high incidence among population aged 15-49 years old.There were 4 asymptomatic infected cases(5.26%),17 mild cases(22.37%),50 common cases(65.79%),4 severe cases(5.26%)and 1 critical case(1.32%);among 76 cases of SARS-CoV-2 Delta variant infection,the lowest Ct value N value of SARS-CoV-2 nucleic acid was 17.5,Lab value was 16.25,the average duration of positive of SARS-CoV-2 nucleic acid was 34.5 days,23 of whom were positive for Ct value of SARS-CoV-2 nucleic acid again 7 days after discharge.The main clinical manifestations were fever and cough.In the early stage of infection,98.68%of patients had normal or decreased white blood cell count,11.84%of patients had slightly increased aspartate aminotransferase/alanine aminotransferase(AST/ALT),and few patients with abnormal creatinine and myocardial enzymes;the proportion of elevation of erythrocyte sedimentation rate(ESR),procalcitonin(PCT)and C-reactive protein(CRP)were 58.21%,5.26%and 31.58%respectively.Among them,55 cases(73.37%)suffered from lung lesions,which were characterized by ground glass shadows,mainly distributed along the subpleura,and some cases were complicated with pleural effusion and consolidation.Conclusion Patients with SARS-CoV-2 Delta variant infection have high viral load and long negative conversion time of nucleic acid,the main clinical manifestations are fever and cough,and the early stage may be accompanied by the increase of AST/ALT.
作者
向柯华
姚媛贞
唐华
田锋
顾娅菲
胡春华
田继先
黄立功
申圣春
雷明盛
粟仲锐
XIANG Ke-hua;YAO Yuan-zhen;TANG Hua;TIAN Feng;GU Ya-fei;HU Chun-hua;TIAN Ji-xian;HUANG Li-gong;SHEN Sheng-chun;LEI Ming-sheng;SU Zhong-rui(Department of Infectious Disease,Zhangjiajie Hospital Affiliated to Hunan Normal University,Zhangjiajie 427000,China;Department of Ophthalmology,Zhangjiajie Hospital Affiliated to Hunan Normal University,Zhangjiajie 427000,China;Department of Pediatrics,Zhangjiajie Hospital Affiliated to Hunan Normal University,Zhangjiajie 427000,China;Department of Critical Care Medicine,Zhangjiajie Hospital Affiliated to Hunan Normal University,Zhangjiajie 427000,China;Department of Emergency,Zhangjiajie Hospital Affiliated to Hunan Normal University,Zhangjiajie 427000,China;Department of Healthcare-associated Infection Management,Zhangjiajie Hospital Affiliated to Hunan Normal University,Zhangjiajie 427000,China;Department of Rehabilitation of Traditional Chinese Medicine,Zhangjiajie Hospital Affiliated to Hunan Normal University,Zhangjiajie 427000,China;Department of Cardiology,Zhangjiajie Hospital Affiliated to Hunan Normal University,Zhangjiajie 427000,China;Department of Respiratory and Critical Care Medicine,Zhangjiajie Hospital Affiliated to Hunan Normal University,Zhangjiajie 427000,China)
出处
《中国感染控制杂志》
CAS
CSCD
北大核心
2021年第11期984-990,共7页
Chinese Journal of Infection Control
