新型冠状病毒肺炎病例呼吸道病毒载量与密切接触者续发风险的关系

吴双胜; 潘阳; 孙瑛; 马春娜; 段玮; 张莉; 王全意; 庞星火

Abstract

吴双胜,潘阳,孙瑛,马春娜,段玮,张莉,王全意,庞星火.新型冠状病毒肺炎病例呼吸道病毒载量与密切接触者续发风险的关系[J].Chinese journal of Epidemiology,2021,42(6):1008-1011

新型冠状病毒肺炎病例呼吸道病毒载量与密切接触者续发风险的关系

Relationship between respiratory viral load of cases of COVID-19 and secondary attack risk in close contacts

Received:February 24, 2021

DOI：10.3760/cma.j.cn112338-20210224-00141

KeyWord: 新型冠状病毒肺炎新型冠状病毒病毒载量传染力密切接触者

English Key Word: COVID-19 SARS-CoV-2 Viral load Infectivity Close contact

FundProject:北京市科技计划（Z201100008920004）；国家自然科学基金（82041027）

Author Name	Affiliation	E-mail
Wu Shuangsheng	Beijing Municipal Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing 100013, China
Pan Yang	Beijing Municipal Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing 100013, China
Sun Ying	Beijing Municipal Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing 100013, China
Ma Chunna	Beijing Municipal Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing 100013, China
Duan Wei	Beijing Municipal Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing 100013, China
Zhang Li	Beijing Municipal Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing 100013, China
Wang Quanyi	Beijing Municipal Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing 100013, China	bjcdcxm@126.com
Pang Xinghuo	Beijing Municipal Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing 100013, China

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Abstract:

目的分析新型冠状病毒肺炎（COVID-19）病例N基因Ct值与其密切接触者续发风险的关系，进而探索呼吸道病毒载量与其传染力的关系。方法选择北京市发病0~7 d内有N基因Ct值记录的COVID-19确诊病例，将其密切接触者作为研究对象。收集密切接触者相关信息，主要包括性别、年龄、隔离方式、暴露方式、转归情况（发病与否）等变量。应用非条件多因素logistic回归模型分析COVID-19病例发病0~7 d内N基因Ct值与其密切接触者转归之间关联。结果在1 618名密切接触者中，77人转归为COVID-19确诊病例或无症状感染者，续发率为4.8%。多因素分析显示，通过同餐（OR=2.741，P=0.054）、同住（OR=9.721，P<0.001）方式暴露、非集中隔离（OR=18.437，P<0.001）、对应病例发病0~7 d内N基因Ct值<20（OR=8.998，P=0.004）或Ct值在20~25之间（OR=3.547，P=0.032）是密切接触者续发风险增加的危险因素。结论 COVID-19病例呼吸道病毒载量与其传染力之间存在明确的正相关，提示COVID-19病例N基因Ct值可以作为其密切接触者管理的参考指标之一。

English Abstract:

Objective To analyze the relationship between the cycle threshold (Ct) values of N gene of COVID-19 cases and the secondary attack risk in close contacts, and identify the relationship between respiratory viral load and infectivity in COVID-19 cases.Methods The COVID-19 cases with records of Ct values of N gene within 0-7 days of onset were selected, and their close contacts were recruited as the subjects of study. We collected the information of close contacts, including name, gender, age, isolation mode, exposure mode and outcome (whether they were infected with SARS-CoV-2 or not) and other variables. Multivariate logistic regression models were used to identify the relationship between Ct values of N gene of COVID-19 cases and secondary attack risk in close contacts. Results A total of 1 618 close contacts were recruited, in whom 77 were confirmed as symptomatic or asymptomatic COVID-19 patients with overall secondary attack rate of 4.8%. The multivariate logistic regression analysis indicated that eating together (OR=2.741, P=0.054), living together (OR=9.721, P<0.001), non-centralized isolation (OR=18.437, P<0.001) and COVID-19 case's values of N gene within 0-7 days of onset being <20 (OR=8.998, P=0.004) or 20-25 (OR=3.547, P=0.032) were significantly associated with higher likelihood of being infected with SARS-CoV-2 in close contacts.Conclusion The results indicated that positive relationship exists between respiratory viral load and infectivity in COVID-19 cases, suggesting that Ct values of N gene can be used as an early warning indicator for the management of close contacts of COVID-19 cases.

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