2022 年中国上海爆发 Omicron BA.2 期间无症状和有症状患者的病毒载量动态:一项纵向队列研究。

IF 5.5 3区 医学 Q1 Medicine
Jingwen Ai, Jiaxin Zhou, Yang Li, Feng Sun, Shijia Ge, Haocheng Zhang, Yanpeng Wu, Yan Wang, Yilin Zhang, Hongyu Wang, Jianpeng Cai, Xian Zhou, Sen Wang, Rong Li, Zhen Feng, Xiangyanyu Xu, Xuemei Yan, Yuchen Zhao, Juanjuan Zhang, Hongjie Yu, Wenhong Zhang
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引用次数: 0

摘要

2022 年,SARS-CoV-2 病毒,尤其是 Omicron BA.2 变体,在上海的发病率大幅上升。然而,临床严重程度不同的Omicron感染的病毒载量动态仍不清楚。该前瞻性队列纳入了2022年3月23日至5月15日期间中国上海三家医院的48830名2019年冠状病毒病(COVID-19)住院患者。采用RT-PCR循环阈值(Ct)作为病毒载量的替代指标,进行了系统的核酸检测。我们按临床严重程度分析了病毒脱落的动力学特征,并确定了相关的风险因素。研究中,无症状病例占 31.06%,轻中度病例占 67.66%,重度病例占 1.00%,危重和死亡病例占 0.29%。入院时,57%的患者检测结果呈阳性,4天时病毒载量达到峰值(中位数Ct值为27.5),随后病毒载量逐渐下降,平均病毒脱落时间(VST)为6.1天(四分位距为4.0-8.8天)。虽然病毒载量因年龄和临床严重程度而异,但 Ct 值峰值出现的时间相似。研究发现,未接种疫苗、年龄超过 60 岁以及合并症(包括高血压、肾病、肾透析和肾移植、神经系统疾病、风湿病和精神病)与病毒载量峰值升高和 VST 延长有关。无症状病例在发现后 6 天内的传染性概率为 40%,而轻中度和重度病例在症状缓解后的传染性概率分别为 27% 和 50%。这些发现表明,最初的 Ct 值可作为严重后果的预测指标。未接种疫苗且有特殊合并症的老年人是病毒载量升高和VST延长的高危人群。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Viral load dynamics in asymptomatic and symptomatic patients during Omicron BA.2 outbreak in Shanghai, China, 2022: a longitudinal cohort study.

The SARS-CoV-2 virus, particularly the Omicron BA.2 variant, led to a significant surge in Shanghai, 2022. However, the viral load dynamic in Omicron infections with varying clinical severities remain unclear. This prospective cohort included 48,830 hospitalized coronavirus disease 2019 (COVID-19) patients across three hospitals in Shanghai, China, between 23 March and 15 May 2022. Systematic nucleic acid testing was performed using RT-PCR Cycle threshold (Ct) value as a proxy of viral load. We analyzed the kinetic characteristics of viral shedding by clinical severity and identified associated risk factors. The study comprised 31.06% asymptomatic cases, 67.66% mild-moderate cases, 1.00% severe cases, 0.29% critical and fatal cases. Upon admission, 57% of patients tested positive, with peak viral load observed at 4 days (median Ct value 27.5), followed by a decrease and an average viral shedding time (VST) of 6.1 days (Interquartile range, 4.0-8.8 days). Although viral load exhibited variation by age and clinical severity, peak Ct values occurred at similar times. Unvaccinated status, age exceeding 60, and comorbidities including hypertension, renal issues kidney dialysis and kidney transplantation, neurological disorders, rheumatism, and psychotic conditions were found to correlate with elevated peak viral load and extended VST. Asymptomatic cases demonstrated a 40% likelihood of contagiousness within 6 days of detection, while mild-moderate and severe cases exhibited post-symptom resolution infectious probabilities of 27% and over 50%, respectively. These findings revealed that the initial Ct values serve as a predictive indicator of severe outcomes. Unvaccinated elderly individuals with particular comorbidities are at high-risk for elevated viral load and prolonged VST.

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来源期刊
Virologica Sinica
Virologica Sinica Biochemistry, Genetics and Molecular Biology-Molecular Medicine
CiteScore
7.70
自引率
1.80%
发文量
3149
期刊介绍: Virologica Sinica is an international journal which aims at presenting the cutting-edge research on viruses all over the world. The journal publishes peer-reviewed original research articles, reviews, and letters to the editor, to encompass the latest developments in all branches of virology, including research on animal, plant and microbe viruses. The journal welcomes articles on virus discovery and characterization, viral epidemiology, viral pathogenesis, virus-host interaction, vaccine development, antiviral agents and therapies, and virus related bio-techniques. Virologica Sinica, the official journal of Chinese Society for Microbiology, will serve as a platform for the communication and exchange of academic information and ideas in an international context. Electronic ISSN: 1995-820X; Print ISSN: 1674-0769
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