无锡市Omicron毒株引起的新型冠状病毒感染者相关持续症状的特征及其影响因素

詹星雅; 刘娟; 冀斌; 沈元

doi:10.16462/j.cnki.zhjbkz.2024.02.015

无锡市Omicron毒株引起的新型冠状病毒感染者相关持续症状的特征及其影响因素

doi: 10.16462/j.cnki.zhjbkz.2024.02.015

詹星雅¹,
刘娟²,
冀斌²,
沈元^2, ,

1.
南京医科大学公共卫生学院，流行病学系，南京 211166
2.
南京医科大学附属无锡疾病预防控制中心急性传染病防制科，无锡 214023

基金项目:

无锡市医学发展学科 FZXK2021010

无锡市科技发展资金项目 Y20212042

详细信息

通讯作者:
沈元，E-mail：sarayshen@163.com

中图分类号: R181.3
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- 被引次数: 0
出版历程
- 收稿日期: 2023-12-01
- 修回日期: 2024-01-24
- 网络出版日期: 2024-03-30
- 刊出日期: 2024-02-10

Characteristics and influencing factors of related persistent symptoms in recovered COVID-19 patients caused by Omicron variant in Wuxi City

ZHAN Xingya¹,
LIU Juan²,
JI Bin²,
SHEN Yuan^{2
, ,}

1.
Nanjing Medical University, School of Public Health, Department of Epidemiology, Nanjing 211166, China
2.
The Affiliated Wuxi Center for Diesase Control and Prevention of Nanjing Medical University, Acute Infectious Disease Control Department, Wuxi 214023, China

Funds:

Wuxi Medical Development Discipline Project FZXK2021010

Wuxi Science and Technology Development Fund Project Y20212042

More Information

Corresponding author: SHEN Yuan, E-mail: sarayshen@163.com

摘要

摘要: 目的探究Omicron毒株引起的新型冠状病毒感染(新冠感染)者康复后3~4个月存在相关持续症状的特征及其影响因素，为制定随访计划、减少感染后相关持续症状提供依据。方法采用自编的躯体与精神神经症状量表、患者健康问卷(patient health questionnaire, PHQ-9)、压力知觉量表(Chinese perceived stress scale, CPSS)、焦虑量表(generalised anxiety disorder scale, GAD-7)和自编的疾病污名化量表进行调查。采用Mann-Whitney U检验、Kruskal-Wallis H检验、χ²检验和二元logistic回归分析模型分析。结果有50.7%的受访者在康复后3~4个月存在相关持续症状，共报告躯体与精神神经症状47种，疲劳乏力是最常见的躯体症状(50.5%)，失眠是最常见的精神神经症状(24.3%)，抑郁和焦虑均与躯体或精神神经症状伴随出现。女性(β=0.70，OR=2.01，95% CI: 1.04~3.86，P=0.037)、隔离期间存在临床症状(β=0.78，OR=2.17，95% CI: 1.13~4.20，P=0.021)、中高压力(β=1.68，OR=5.35，95% CI: 2.14~13.38，P＜0.001)、严重污名化(β=1.03，OR=2.79，95% CI: 1.33~5.83，P=0.006)是新冠感染者出院3~4个月后存在持续症状的危险因素。结论部分新冠感染者康复后3~4个月时仍存在相关持续症状。重点关注可能出现相关持续症状的高风险人群，并同时在医疗保健和精神心理卫生方面给予支持。
- 新型冠状病毒感染 /
- Omicron毒株 /
- 持续症状 /
- 影响因素
Abstract: Objective To explore the characteristics and determinants of persistent symptoms in individuals 3-4 months post-recovery from the Omicron variant-induced COVID-19 infection. The insights gained serve to inform the development of follow-up plans, with the goal of mitigating post-infection symptoms. Methods Surveys were conducted utilizing self-developed somatic and neuropsychiatric symptom scales, the patient health questionnaire-9 (PHQ-9), the Chinese perceived stress scale (CPSS), the generalised anxiety disorder-7 (GAD-7) scale, and the novel disease stigmatization scale. Data analyses were performed using Mann-Whitney U tests, Kruskal-Wallis H tests, chi-square tests, and binary logistic regression models. Results 50.7% of participants reported persistent related symptoms three to four months post-recovery, with 47 types of somatic and neuropsychiatric symptoms identified. Fatigue emerged as the most prevalent somatic symptom (50.5%), while insomnia was the most frequently reported neuropsychiatric symptom (24.3%). Both depression and anxiety were observed to commonly co-occur with these somatic or neuropsychiatric symptoms. Risk factors associated with the persistence of symptoms 3-4 months after discharge from COVID-19 infection included being female (β=0.70, OR=2.01, 95% CI: 1.04-3.86, P=0.037), presentation of clinical symptoms during the quarantine (β=0.78, OR=2.17, 95% CI: 1.13-4.20, P=0.021), moderate to high stress levels (β=1.68, OR=5.35, 95% CI: 2.14-13.38, P < 0.001), and severe stigmatization (β=1.03, OR=2.79, 95% CI: 1.33-5.83, P=0.006). Conclusions A subset of individuals recovering from COVID-19 continue to experience related symptoms three to four months post-recovery. Attention should be focused on high-risk groups who may present with persistent symptoms, ensuring they receive comprehensive support in terms of healthcare and mental health services.
- COVID-19 /
- Omicron variant /
- Persistent symptoms /
- Influencing factors

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图 1 躯体与精神神经症状共现网络

括号中数据为症状总响应人次与总响应人数占比。

Figure 1. Somatic and psychoneurotic symptom co-occurrence network

Data in parentheses are percentages of total symptom responders and total responders.

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表 1 不同基本特征新型冠状病毒感染者存在相关持续症状情况的比较

Table 1. Current status and difference analysis of persistent symptoms of COVID-19 in patients with different basic characteristics

变量 Variable	无持续症状受访者人数(占比/%) Number of no persistent symptoms(proportion/%)	有持续症状受访者人数(占比/%) Number of having persistent symptoms(proportion/%)	χ²值 value	P值 value
性别 Gender			1.775	0.183
男性 Male	52(52.5)	44(43.1)
女性 Female	47(47.5)	58(56.9)
年龄组/岁 Age group/years			0.785	0.940
18~＜31	15(15.2)	19(18.6)
31~＜41	21(21.2)	23(22.5)
41~＜51	28(28.3)	29(28.4)
51~＜61	29(29.3)	26(25.5)
≥61	6(6.1)	5(4.9)
原籍 Domicile place			3.445	0.179
无锡市 Wuxi City	28(28.3)	19(18.6)
江苏省其他市 Other cities in Jiangsu Province	29(29.3)	40(39.2)
省外 Other Provinces	42(42.4)	43(42.2)
职业 Occupation			4.406	0.493
工人 Workers	46(46.5)	39(38.2)
技术人员 Technicists	16(16.2)	24(23.5)
家务、待业或离退人员 Housework, unemployment or retiree	12(12.1)	18(17.6)
个体户 Individual household	7(7.1)	5(4.9)
商业服务 Commercial service	8(8.1)	5(4.9)
其他 Others	10(10.1)	11(10.8)
疫苗接种剂次 Dose of vaccine			2.890	0.409
未接种 Unvaccinated	4(4.0)	3(2.9)
1剂次 dose	2(2.0)	2(2.0)
2剂次 doses	21(21.2)	13(12.7)
3剂次 doses	72(72.7)	84(82.4)
隔离期间存在临床症状 Presentation of clinical symptoms during the quarantine			9.112	0.011
否 No	65(65.7)	46(45.1)
是 Yes	30(30.3)	52(51.0)
未知 Unknown	4(4.0)	4(3.9)
基础疾病 Comorbidity			3.418	0.181
无 No	51(51.5)	54(52.9)
有 Yes	9(9.1)	17(16.7)
未知 Unknown	39(39.4)	31(30.4)

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表 2 不同特征受访者的症状群得分差异

Table 2. Differences in symptom cluster scores among respondents with different characteristics

变量 Variable	躯体与精神神经症状总分 ^① Total score of physical and neuropsychological symptoms ^①	PHQ-9总分 ^① Total score of PHQ-9 ^①	GAD-7总分 ^① Total score of GAD-7 ^①
性别 Gender
男性 Male	0.00(0.00, 8.00)	0.00(0.00, 2.00)	0.00(0.00, 1.00)
女性 Female	1.00(0.00, 10.50)	0.00(0.00, 2.00)	0.00(0.00, 1.00)
Z值 value	-0.960	-0.472	-0.728
P值 value	0.337	0.637	0.467
年龄组/岁 Age group/years
18~ < 31	3.00(0.00, 5.25)	0.00(0.00, 2.00)	0.00(0.00, 0.00)
31~ < 41	2.00(0.00, 12.75)	1.00(0.00, 3.00)	0.00(0.00, 1.00)
41~ < 51	1.00(0.00, 14.50)	0.00(0.00, 2.25)	0.00(0.00, 1.00)
51~ < 61	0.00(0.00, 7.00)	0.00(0.00, 2.00)	0.00(0.00, 1.00)
≥61	0.00(0.00, 6.00)	0.00(0.00, 0.00)	0.00(0.00, 1.00)
H值 value	1.426	6.343	7.733
P值 value	0.840	0.175	0.102
原籍 Domicile place
无锡市 Wuxi City	0.00(0.00, 8.00)	0.00(0.00, 2.00)	0.00(0.00, 1.00)
江苏省其他市 Other cities in Jiangsu Province	2.00(0.00, 13.50)	0.00(0.00, 3.00)	0.00(0.00, 1.00)
省外 Other Provinces	1.00(0.00, 5.50)	1.00(0.00, 2.00)	0.00(0.00, 1.00)
H值 value	3.909	2.708	1.368
P值 value	0.142	0.258	0.505
职业 Occupation
工人 Workers	0.00(0.00, 7.00)	0.00(0.00, 1.00)	0.00(0.00, 0.00)
技术人员 Technicists	4.50(0.00, 13.50)	1.00(0.00, 3.75)	0.00(0.00, 1.75)
家务、待业或离退人员 Housework, unemployment or retiree	5.00(0.00, 17.25)	1.00(0.00, 4.00)	0.00(0.00, 1.25)
个体户 Individual household	0.00(0.00, 4.75)	1.00(0.00, 2.00)	0.00(0.00, 1.50)
商业服务 Commercial service	0.00(0.00, 9.50)	0.00(0.00, 2.00)	0.00(0.00, 0.50)
其他 Others	1.00(0.00, 4.00)	0.00(0.00, 2.00)	0.00(0.00, 1.00)
H值 value	7.516	10.833	8.981
P值 value	0.185	0.055	0.110
疫苗接种剂次 Dose of vaccine
未接种 Unvaccinated	0.00(0.00, 11.00)	1.00(0.00, 4.00)	2.00(0.00, 2.00)
1剂次 dose	4.00(0.00, 8.00)	1.00(0.25, 4.00)	―
2剂次 doses	0.00(0.00, 5.00)	0.00(0.00, 2.00)	0.00(0.00, 0.00)
3剂次 doses	1.50(0.00, 10.00)	0.00(0.00, 2.00)	0.00(0.00, 1.00)
H值 value	2.098	1.811	9.713
P值 value	0.552	0.612	0.021
隔离期间存在临床症状 Presentation of clinical symptoms during the quarantine
否 No	0.00(0.00, 6.00)	0.00(0.00, 1.00)	0.00(0.00, 1.00)
是 Yes	4.00(0.00, 11.00)	1.00(0.00, 3.00)	0.00(0.00, 1.00)
未知 Unknown	1.50(0.00, 4.50)	0.00(0.00, 1.00)	―
H值 value	6.454	8.255	4.186
P值 value	0.040	0.016	0.123
基础疾病 Comorbidity
无 No	1.00(0.00, 10.50)	0.00(0.00, 2.00)	0.00(0.00, 1.00)
有 Yes	5.00(0.00, 22.25)	1.00(0.00, 4.25)	1.00(0.00, 2.00)
未知 Unknown	0.00(0.00, 6.25)	0.00(0.00, 1.00)	0.00(0.00, 0.00)
H值 value	5.619	11.275	9.423
P值 value	0.060	0.004	0.009
知觉压力水平 Level of perceived Stress
低 Low	0.00(0.00, 5.00)	0.00(0.00, 1.00)	0.00(0.00, 0.00)
中 Moderate	10.50(3.00, 17.75)	3.00(1.25, 4.00)	1.00(1.00, 2.00)
高 High	―	―	―
H值 value	32.856	62.347	66.731
P值 value	＜0.001	＜0.001	＜0.001
污名化水平 Level of stigmatization
轻度 Low	0.00(0.00, 2.00)	0.00(0.00, 0.00)	0.00(0.00, 0.00)
中度 Moderate	0.00(0.00, 5.00)	0.00(0.00, 1.50)	0.00(0.00, 0.00)
严重 Severe	8.50(0.00, 17.25)	2.00(1.00, 4.25)	1.00(0.00, 2.00)
H值 value	36.711	59.152	59.419
P值 value	＜0.001	＜0.001	＜0.001
注：PHQ-9, 患者健康问卷; GAD-7, 焦虑量表；“―”表示此类人群样本量不足，用中位数和四分位数无法表示。 ①以M(P₂₅，P₇₅)表示。 Note: PHQ-9, patient health questionnaire; GAD-7, generalised anxiety disorder scale; The "―" symbol indicates that the sample size of this population is insufficient to be represented by the median and quartile. ① M(P₂₅，P₇₅).

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表 3 新型冠状病毒感染相关持续症状多因素分析

Table 3. Multivariate analysis of persistent symptoms associated with COVID-19

变量 Variable	β值 value	s_x	Wald值 value	OR值value (95% CI)	P值 value
性别 Gender
男性 Male				1.00
女性 Female	0.70	0.33	4.33	2.01(1.04~3.86)	0.037
年龄/岁 Age/years	-0.02	0.02	1.25	0.98(0.96~1.01)	0.264
基础疾病 Comorbidity
无 No				1.00
有 Yes	0.53	0.58	0.86	1.71(0.55~5.28)	0.355
未知 Unknown	0.42	0.38	1.24	1.52(0.73~3.17)	0.266
隔离期间存在临床症状 Presentation of clinical symptoms during the quarantine
否 No				1.00
是 Yes	0.78	0.34	5.34	2.17(1.13~4.20)	0.021
未知 Unknown	0.30	0.80	0.14	1.35(0.28~6.48)	0.705
知觉压力水平 Level of perceived stress
低 Low				1.00
中高 Moderate or high	1.68	0.47	12.87	5.35(2.14~13.38)	＜0.001
污名化水平 Level of stigmatization
轻中度 Low or moderate				1.00
严重 Severe	1.03	0.38	7.43	2.79(1.33~5.83)	0.006

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