文章摘要
谢仕兰,黄建华,刘珺,刘隽,龙其穗,谢莘,廖宇煌,唐玲玲,梁文佳,钟豪杰,李艳.广东省新型冠状病毒肺炎无症状感染者流行病学特征分析[J].中华流行病学杂志,2020,41(9):1406-1410
广东省新型冠状病毒肺炎无症状感染者流行病学特征分析
Epidemiological characteristics of asymptomatic infection cases of COVID-19 in Guangdong province
收稿日期:2020-04-23  出版日期:2020-09-18
DOI:10.3760/cma.j.cn112338-20200423-00633
中文关键词: 新型冠状病毒肺炎;无症状感染者;流行特征
英文关键词: COVID-19;Asymptomatic infection cases;Epidemiological characteristic
基金项目:
作者单位E-mail
谢仕兰 广东省疾病预防控制中心艾滋病预防控制所, 广州 511430  
黄建华 广东省疾病预防控制中心公共卫生应急部, 广州 511430  
刘珺 广东省疾病预防控制中心艾滋病预防控制所, 广州 511430  
刘隽 广东省疾病预防控制中心办公室, 广州 511430  
龙其穗 广东省疾病预防控制中心艾滋病预防控制所, 广州 511430  
谢莘 广东省疾病预防控制中心免疫所, 广州 511430  
廖宇煌 广东省疾病预防控制中心寄生虫病预防控制所, 广州 511430  
唐玲玲 广东省疾病预防控制中心基层卫生与地方病预防控制所, 广州 511430  
梁文佳 广东省疾病预防控制中心免疫所, 广州 511430  
钟豪杰 广东省疾病预防控制中心公共卫生应急部, 广州 511430  
李艳 广东省疾病预防控制中心艾滋病预防控制所, 广州 511430 13580581074@126.com 
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中文摘要:
      目的 对广东省首次报告为新型冠状病毒肺炎(COVID-19)无症状感染者个案流行病学特征进行分析。方法 采用追踪观察方法,对广东省2020年1月14日至3月31日首次报告为COVID-19无症状感染者的个案进行持续追踪观察,收集流行病学相关资料,分析其流行病学特征和转归及影响因素。结果 2020年1月14日至3月31日共报告325例COVID-19无症状感染者,其流行曲线与确诊病例流行曲线相似,出现两个峰,分别在1月27日至2月5日和3月17-26日。325例个案中,184例(占56.6%)后续转为确诊病例,为潜伏期无症状感染者,其年龄M为40岁,93.5%(172/184)的潜伏期无症状感染者在首次采样检测核酸阳性3 d内出现症状;141例(占43.4%)持续无症状,属于隐性感染者,占同期报告新型冠状病毒感染者的8.6%(141/1 642),其年龄M为27岁,从首次采样检测阳性到出院时间M为14 d,90.8%(138/141)的隐性感染者在28 d内出院转集中隔离观察,从首次采样检测核酸阳性到末次采样检测阳性时间间隔最长73 d。隐性感染者关联的密切接触者检出阳性率为0.3%,潜伏期无症状感染者关联的密切接触者检出阳性率为2.2%。潜伏期无症状感染者和隐性感染者年龄、感染来源构成差异均有统计学意义(P<0.05)。高年龄组为首次报告为“COVID-19无症状感染者”转为确诊病例的危险因素,与0~19岁组比较,40~59岁、≥60岁均为无症状感染者转确诊的危险因素,OR值(95% CI)分别为2.730(1.380~5.402)和5.302(2.199~12.783),P值分别为0.004和0.000。境内感染无症状感染者更易转为确诊病例(OR=7.121,P=0.000)。结论 新型冠状病毒感染者中存在无症状感染现象,潜伏期无症状感染者传染性可能强于隐性感染者,高年龄组、境内感染是无症状感染者转为确诊病例的危险因素,需引起关注,后续需要在人群中开展血清学调查,为防控策略制定提供依据。
英文摘要:
      Objective To analyze the epidemiological characteristics of the cases firstly reported as “asymptomatic infection of COVID-19” in Guangdong province. Methods The follow-up observation method was used to continuously track and observe the cases firstly reported as “asymptomatic patients with COVID-19” in Guangdong province from January 14 to March 31, 2020. The epidemiological data of the cases were collected to analyze their epidemiological characteristics, outcome and influencing factors. Results From January 14 to March 31, 2020, a total of 325 cases were firstly reported as “asymptomatic infections of COVID-19” in Guangdong province. The epidemic curve of asymptomatic infection cases was similar to that of confirmed cases, and it had two peaks. The first peak was from January 27 to February 5, and the second peak was from March 17 to March 26. Of the 325 cases, 184 (56.6%) were subsequently converted to confirmed cases. These cases were defined as incubation period asymptomatic infection cases. The age median of the cases was 40 years, and 93.5% (172/184) of the cases showed symptoms within 3 days after the first positive nucleic acid tests were conducted, and 141 (43.4%) of the 325 cases remained asymptomatic status until they were cured and discharged. They were inapparent infection cases, accounting for 8.6% (141/1 642) of those diagnosed with COVID-19 in Guangdong province during the same period. The age median of inapparent infection cases was 27 years. The median of the interval between the first positive nucleic acid test and discharge was 14 days. Up to 90.8% (138/141) of the inapparent infection cases were discharged for centralized medical observation within 28 days. The longest interval between the first positive nucleic acid test and the last positive nucleic acid test was 73 days. The positive rate of nucleic acid test was 0.3% in close contacts of inapparent infection cases and 2.2% in close contacts of incubation period asymptomatic infection cases. There were significant differences in age distribution and source of infection between incubation period asymptomatic infection cases and inapparent infection cases (P<0.05). Old age was the risk factor for the conversion of firstly reported asymptomatic infection cases to confirmed cases. Compared with the 0-19-year-old group, The patients aged 40-59 years and 60 years and above were more likely to become confirmed cases. The OR (95% CI) values were 2.730 (1.380-5.402) and 5.302 (2.199-12.783), and P values were 0.004 and 0.000, respectively. People being infected in China were more likely to become confirmed cases (OR=7.121, P=0.000). Conclusions There were asymptomatic infection cases among patients diagnosed with COVID-19. The infectiousness of incubation period asymptomatic infection cases might be stronger than that of inapparent infection cases. The proportion of younger cases among asymptomatic infection cases was higher than that of the confirmed cases. Old age and domestic infection were the risk factors for the conversion of asymptomatic infection cases to confirmed cases, to which more attention should be paid. Further serological investigations are needed to provide a basis for the development of COVID-19 prevention and control strategies.
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