Clinical Epidemiology, Illness Profiles, and the Implication of COVID-19 Before and After the Nationwide Omicron Outbreak During the Winter of 2022

Yuming Guo, Zhe Xu, Wen-Xin Wang, C. Zhen, Jinhua Hu, Jinsong Mu, Chengcheng Ji, Xin Yuan, R. Xu, Lei Huang, Lei Shi, F. Meng, Jun‐liang Fu, Shuangnan Zhou, Siyu Wang, Fengyi Li, B. Tu, Dawei Zhang, Hui‐huang Huang, Yufeng Mao, Wenxin Xu, Chao Zhang, X. Mu, Jun Zhao, B. Jin, Haibin Su, Yinying Lu, Yongqian Cheng, Dong Ji, Shaoli You, Jing-hui Dong, Changchun Liu, Mengmeng Zhang, Yuan-yuan Li, T. Jiang, Yonggang Li, Furang Wang
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Abstract

Abstract Background The outbreak and prevalence of the Omicron variant have threatened human health since March 2022 in mainland China. In this study, we aimed to investigate the clinical characteristics and outcomes of patients with coronavirus disease 2019 (COVID-19) in the Beijing region. Methods In this retrospective study, we enrolled inpatients admitted for COVID-19 in the Fifth Medical Center of Chinese PLA General Hospital in Beijing between November 10, 2022, and January 30, 2023. Demographic and clinical features and treatment outcomes were comprehensively analyzed. We used logistic regression and linear regression analyses to explore the risk factors associated with disease severity and time of nucleic acid conversion, respectively. Results A total of 1010 hospitalized patients with COVID-19 were enrolled. The median age was 43.0 years (interquartile range, 28.0–63.0), and patients aged <60 years and ≥60 years comprised 71.2% and 28.8% of total included patients, respectively. The clinical classification of mild (74.6%, 753/1010), moderate (21.0%, 212/1010), severe (2.7%, 27/1010), and unidentified (1.8%, 18/1010) was separately recorded; 1005 patients were discharged, and 5 patients died in the hospital. The outbreak of the emerging epidemic witnessed an evident increase in the proportion of moderate (42.9% vs. 16.4%) and severe (10.3% vs. 1.1%) cases after December 7, 2022. Patients with a moderate/severe classification had higher levels of procalcitonin, IL-6, serum ferritin, C-reactive protein, lactic dehydrogenase, serum urea nitrogen, and d-dimer and lower counts of CD4+ T, CD8+ T, and B cells (all P < 0.001). Multivariable regression analysis revealed that increased odds of disease severity were associated with the following factors: age ≥60 years, IL-6 > 7 pg/mL, lactic dehydrogenase level >245 U/L, cough, and fever at admission. Age ≥80 years and chronic lung disease were independent risk factors in the nonmild group in elderly patients. In addition, the duration for nucleic acid to turn negative was approximately 5.0 d (interquartile range, 3.0–7.0). Prolonged time of nucleic acid conversion was associated with age ≥60 years, serum urea nitrogen level >8.2 mmol/L, neutrophil count >7 ×109/L, and the presence of a chronic lung disease or carcinoma. Finally, unvaccinated patients accounted for 37.3% of enrolled patients; children and the elder people accounted for approximately half of that. The univariable analysis found that booster doses reduced disease severity and shortened the time of nucleic acid conversion in elderly patients. Conclusions The outbreak of Omicron rapidly increased the number of patients with COVID-19 in Beijing. In elderly patients, booster doses may reduce disease severity and shorten the time of nucleic acid conversion. Healthcare systems should be optimized before an emerging epidemic outbreak.
2022 年冬季全国范围内爆发欧米茄疫情前后的临床流行病学、疾病概况以及 COVID-19 的影响
摘要 背景 2022年3月以来,奥米克变异株在中国大陆的爆发和流行威胁着人类健康。本研究旨在调查北京地区冠状病毒病 2019(COVID-19)患者的临床特征和预后。方法 在这项回顾性研究中,我们纳入了2022年11月10日至2023年1月30日期间在北京中国人民解放军总医院第五医学中心收治的COVID-19住院患者。我们对患者的人口统计学特征、临床特征和治疗结果进行了全面分析。我们采用逻辑回归和线性回归分析分别探讨了与疾病严重程度和核酸转换时间相关的风险因素。结果 共纳入了 1010 名 COVID-19 住院患者。中位年龄为 43.0 岁(四分位距为 28.0-63.0),入院时年龄为 7 pg/mL、乳酸脱氢酶水平 >245 U/L、咳嗽和发烧。年龄≥80 岁和慢性肺部疾病是非轻度组老年患者的独立风险因素。此外,核酸转阴的时间约为 5.0 d(四分位数间距,3.0-7.0)。核酸转阴时间延长与年龄≥60岁、血清尿素氮水平>8.2 mmol/L、中性粒细胞计数>7 ×109/L、患有慢性肺部疾病或癌症有关。最后,未接种疫苗的患者占登记患者的 37.3%;儿童和老年人约占一半。单变量分析发现,加强剂量可减轻老年患者的疾病严重程度并缩短核酸转换时间。结论 Omicron 的爆发使北京的 COVID-19 患者人数迅速增加。在老年患者中,加强剂量可减轻疾病的严重程度并缩短核酸转换时间。在新的流行病爆发之前,应优化医疗保健系统。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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