福建省新型冠状病毒肺炎患者密切接触者的流行病学特征与感染危险因素

陈武; 林嘉威; 吴生根; 陈斌; 林少凯; 林熙; 邓艳琴; 王灵岚; 欧剑鸣; 郑奎城

doi:10.16462/j.cnki.zhjbkz.2020.05.013

福建省新型冠状病毒肺炎患者密切接触者的流行病学特征与感染危险因素

doi: 10.16462/j.cnki.zhjbkz.2020.05.013

350001 福州, 福建省疾病预防控制中心福建省人兽共患病研究重点实验室

陈武和林嘉威为共同第一作者

基金项目: 福建省社会发展引导性项目(2020Y0005);福建省科技计划项目(2016R0026)

详细信息

通讯作者:
郑奎城, E-mail:kingdadi9909@126.com

中图分类号: R195.1
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出版历程
- 收稿日期: 2020-03-17
- 修回日期: 2020-03-27
- 刊出日期: 2020-05-10

Epidemiological characteristics and infection risk factors of people with close contact with coronavirus disease 2019 patients in Fujian Province

Department of Emergency Prepare and Respond of Fujian Provincial Center for Control and Prevention, Fujian Provincial Key Laboratory of Zoonosis Research, Fuzhou 350001, China

CHEN Wu and LIN Jia-wei contributed equally to this article

Funds: Fujian Province Social Development Guiding Project(2020Y0005); Fujian Province Science and Technology Project(2016R0026)

More Information

Corresponding author: ZHENG Kui-cheng, E-mail:kingdadi9909@126.com

摘要

摘要: 目的探讨新型冠状病毒肺炎(coronavirus disease 2019, COVID-19)患者的密切接触者的流行病学特征和感染的危险因素。方法描述2020年福建省111名COVID-19患者的密切接触者特征, 以111名(102名确诊和9名无症状感染者)感染新型冠状病毒的密切接触者为病例组, 以未感染新型冠状病毒且资料完整的2 337名密切接触者为对照组, 采用Logistic回归分析模型探讨密切接触者感染的危险因素。结果 111例中男性57名, 女性54名, 男女比为1.1:1, 年龄中位数为49.5岁, 密切接触者感染率为1.7%(111/6 718)。引起47起聚集性疫情, 占总起数88.7%(47/53), 占总病例数54.7%(162/296), 有7例潜伏期超过14 d, 最长达21 d, 1起聚集性疫情显示原代病例发病前2 d具有感染性。家庭续发率4.2%(73/1 739)、社区续发率为10.1%(24/237)、养老院续发率2.7%(7/256)、社交场所续发率为2.0%(4/199)、工作场所续发率3.0%(3/99), 续发率差异有统计学意义(χ²=20.76, P < 0.001)。确诊病例以轻型和普通型为主(88.2%), 临床严重程度与原代病例没有区别。最后接触到确定密切接触者时间中位数为2 d, 确定密切接触者到实施隔离时间为中位数1 d, 最后接触到发病时间中位数为7 d, 发病至就诊时间中位数为4.9 d, 就诊到确诊均在当天完成。多因素分析结果显示, 随着年龄的增大, 感染风险越大, 15~岁(OR=4.22, 95% CI:1.79~9. 96)和≥50岁(OR=6.61, 95% CI:2.77~15.78);接触频率时间越久, 受感染的机会越大, 一般接触(OR=3.58, 95% CI:1.70~7.54)和经常接触(OR=8.30, 95% CI:4.65~14.80);暴露于现症病例(OR=3.64, 95% CI:1.65~8.04)更易感染。结论新型冠状病毒续发率较高, 在2.0%以上; 感染新型冠状病毒的密切接触者临床严重程度与原代病例没有差别, 均以轻症为主, 年龄、接触频率和原代病例有无症状是其危险因素; 密切接触者协同追踪管理信息化程度不高, 成效不理想。
- 新型冠状病毒肺炎 /
- 密切接触者 /
- 流行病学 /
- 感染 /
- 危险因素
Abstract: Objective To investigate the epidemiological characteristics and risk factors of close contacts of coronavirus disease 2019(COVID-19). Methods The characteristics of 111 close contacts of COVID-19 infection in Fujian Province in 2020 were described. Taking 111 close contacts of COVID-19 infection(102 confirmed and 9 asymptomatic infections) as the case group, and 2 337 non-infected close contacts as comparing group, Logistic regression analysis model was used to explore the risk factors of close contact infection. Results Among the 111 cases, 57 were males and 54 were females. The gender ratio was 1.1:1. The infection rate of close contacts is 1.7%(111/6 718) the median age of the close contacts was 49.5 years. 111 cases resulted in 47 clustering outbreaks. the incubation period of 7 cases was over 14 days. The tongest incubation period was up to 21 days. One outbreak revealed the disease could infected others 2 days before the onset of the primary case. The secondary attack rate in family was 4.2%(73/1 739), and in community was 10.1%(24/237), in nursing homes was 2.7 %(7/256), in social places was 2.0%(4/199), and in workplace was 3.0%(3/99). The difference was statistically significant(χ²=20.76, P < 0.001). The confirmed cases were mainly light and common type(88.2%), and the clinical severity of those in close contacts was no different from that of primary cases. The median of the interval time between final exposure to identification close contacts was 2 days. The median of the interval time between the identification close contacts to isolation was 1 day. The median of the interval time between the final exposure to the onset of the disease was 7 days. The median of the interval time between the onset to visit was 4.9 days. Those of 15-years(OR=4.22, 95% CI:1.79-9.96) and ≥50 years(OR=6.61, 95% CI:2.77-15.78) were more likely to develop infection. In comparison with occasional contact, those of general contact(OR=3.58, 95% CI:1.70-7.54) and regular contact(OR=8.30, 95% CI:4.65-14.80) were more likely to develop infection. And those exposed confirmed cases(OR=3.64, 95% CI:1.65-8.04) were at higher risk of infection as well. Conclusions The recondary attack rate of COVID-19 is higher than 2.0%. The clinical severity of close contacts infected with COVID-19 is not different from that of the primary cases. Age, frequency of exposure and primary cases in asymptomatic phase are the risk factors for close contacts of COVID-19. The degree of informatization of close contact tracking management is not high, and the results are not satisfactory.
- COVID-19 /
- Close contactors /
- Epidemiology /
- Infection /
- Risk factors

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图 1 福建省新型冠状病毒肺炎病例报告曲线图

Figure 1. Day distribution of COVID-19 case in Fujian Province

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表 1 福建省COVID-19聚集性疫情发生情况

Table 1. The situation of clusters of COVID-19 in Fujian Province

场所	起数	原代病例数	续发病例数	密切接触者人数	平均传染人数	续发率(%)
家庭	39	50	73	1 739	1.5	4.2
社区	2	4	24	237	6.0	10.1
养老院	1	1	7	256	7.0	2.7
社交场所	3	3	4	199	1.3	2.0
工作场所	2	2	3	99	1.5	3.0
合计	47	60	111	2 530	1.9	4.4

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表 2 新型冠状病毒肺炎(COVID-19)密切接触者感染危险因素Logistic回归分析

Table 2. Unconditional Logistic regression analysis for factors associated withnovel coronavirus pneumonia(COVID-19)infection among close contacts

危险因素	病例组(n=111)	对照组(n=2 337)	单因素		多因素
危险因素	病例组(n=111)	对照组(n=2 337)	OR(95% CI)值	P值	OR(95% CI)值	P值
接触患者时带口罩
否	111(100.0)	2 195(94.0)	1.00
是	0(0.0)	142(6.0)	10.30(1.89~Infinity)	0.002^a	-
接触频率(min)
偶尔(< 10)	14(12.6)	1 136(48.6)	1.00		1.00
一般(10~)	15(13.5)	379(16.2)	3.21(1.54~6.71)	0.002	3.58(1.70~7.54)	< 0.001
经常(> 1 h)	82(73.9)	822(35.2)	8.09(4.56~14.37)	< 0.001	8.30(4.65~14.80)	< 0.001
接触方式
其他	22(19.8)	1 114(47.7)	1.00
共同居住	67(60.4)	757(32.4)	4.48(2.75~7.32)	< 0.001	-
聚餐打牌	22(19.8)	466(19.9)	2.39(1.31~4.36)	0.041	-
接触时患者发病
否	7(6.3)	528(22.6)	1.00		1.00
是	104(93.7)	1 809(77.4)	4.34(2.01~9.38)	< 0.001	3.64(1.65~8.04)	0.001
年龄组(岁)
0~	6(5.4)	353(15.1)	1.00		1.00
15~	57(51.4)	1 248(53.4)	2.69(1.15~6.28)	0.023	4.22(1.79~9.96)	0.001
≥50	48(43.2)	736(31.5)	3.84(1.63~9.06)	0.002	6.61(2.77~15.78)	< 0.001
与原发病例的关系
非家属	24(21.6)	1 051(45.0)	1.00
家属	87(78.4)	1 286(55.0)	2.96(1.87~4.69)	< 0.001	-
性别
男	57(51.4)	1 328(56.8)	1.00
女	54(48.6)	1 009(43.2)	1.25(0.85~1.83)	0.256	-
场所
居家	8(7.2)	194(8.3)	1.00
集中	103(92.8)	2 143(91.7)	1.17(0.56~2.43)	0.683	-
注:^a表示使用Fisher确切概率法。

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参考文献(11)

[1]	中华预防医学会新型冠状病毒肺炎防控专家组.新型冠状病毒肺炎流行病学特征的最新认识[J].中华流行病学杂志, 2020, 41(2): 139-144.DOI: 10.3760/cma.j.issn.0254-6450.2020.02.002. Special Expert Group for Control of the Epidemic of Novel Coronavirus Pneumonia of the Chinese Preventive Medicine Association. An update on the epidemiological characteristics of novel coronavirus pneumonia(COVID-19)[J]. Chin J Epidemiol, 2020, 41(2): 139-144. DOI: 10.3760/cma.j.issn.0254-6450.2020.02.002.
[2]	国家卫生健康委员会办公厅.新型冠状病毒肺炎防控方案(第六版)[EB/OL]. (2020-03-07)[2020-03-07]. http://www.nhc.gov.cn/xcs/zhengcwj/202003/4856d5b0458141fa9f376853224d41d7.shtml. General Office of National Health Commission. Prevention and control protocol for Novel Coronavirus Pneumonia(version6)[EB/OL]. http://www.nhc.gov.cn/xcs/zhengcwj/202003/4856d5b0458141fa9f376853224d41d7.shtml.
[3]	中国疾病预防控制中心.新型冠状病毒肺炎病例密切接触者调查与管理指南(试行版)[EB/OL]. (2020-02-15)[2020-02-24]. http://www.chinacdc.cn/jkzt/crb/zl/szkb_11803/jszl_11815/202002/t20200224_213676.html. Chinese Center for Disease Control and Prevention. Investigation and administration technical guideline for close contacts of the 2019 novel coronavirus pneumonia(COVID-19), China(Trial Version). [EB/OL]. (2020-02-15)[2020-02-24]. http://www.chinacdc.cn/jkzt/crb/zl/szkb_11803/jszl_11815/202002/t20200224_213676.html.
[4]	中华人民共和国健康委员会. 2020年2月4日新闻发布会文字实录[EB/OL]. (2020-02-04)[2020-02-24].http://www.nhc.gov.cn/xcs/yqfkdt/202002/35990d56cfcb43f4a70d7f9703b113c0.shtml.
[5]	陈伟, 王晴, 李媛秋, 等.我国新型冠状病毒肺炎疫情早期围堵策略概述[J].中华预防医学杂志, 2020, 54(3): 239-243.DOI: 10.3760/cma.j.issn.0253-9624.2020.03.003. Chen W, Wang Q, Li YQ, et al. Early containment strategies and core measures for prevention and control of novel coronavirus pneumonia in China[J]. Chin J Prevent Med, 2020, 54(3): 239-243. DOI: 10.3760/cma.j.issn.0253-9624.2020.03.003.
[6]	杨鹏, 李爽, 张莉, 等.甲型H1NI流感密切接触者感染危险因素的病例对照研究[J].中华疾病控制杂志, 2010, 16(4): 318-320. http://www.cqvip.com/QK/80677A/20124/41540636.html Yang P, Li S, Zhang L, et al. A case-control study on risk factors for 2009 H1N1 influenza infection among close contacts[J]. Chin J Dis Control Prev, 2010, 16(4): 318-320. http://www.cqvip.com/QK/80677A/20124/41540636.html
[7]	Zhang L, Liu YH. Potential interventions for novel coronavirus in China: a systematic review[J]. J Med Virol, 2020, 92(5): 479-490.DOI: 10.1002/jmv.25707.
[8]	杨海燕, 徐洁, 李岩, 等.新型冠状病毒肺炎聚集性疫情特征初步分析[J].中华流行病学杂志, 2020, 41(5): 623-628.DOI: 10.3760/cma.j.cn112338-20200223-00153. Yang HY, Xu J, Li Y, et al. The preliminary analysis on the characteristics of the cluster for the corona virus disease[J]. Chin J Epidemiol, 2020, 41(5): 623-628. DOI: 10.3760/cma.j.cn112338-20200223-00153.
[9]	Yang Y, Lu QB, Liu MJ, et al. Epidemiological and clinical features of the 2019 novel coronavirus outbreak in China[J]. medRxiv, 2020.DOI: 10.1101/2020.02.10.20021675.
[10]	Wang P, Lu JA, Jin YY, et al. Epidemiological characteristics of 1212 COVID-19 patients in Henan, China[J]. medRxiv preprint, 2020.DOI: 10.1101/2020.02.21.20026112.
[11]	庞星火, 杨鹏, 李爽, 等.北京市2009年甲型H1NI流感患者密切接触者的流行病学特点[J].中华结核和呼吸杂志, 2011, 34(5): 348-352.DOI: 10.3760/cma.j.issn.1001-0939.2011.05.010. Pang XH, Yang P, Li S, et al. Epidemiological characteristics of infection for close contacts of pandemic(H1N1)2009 in Beijing[J]. Chin J Tubere Respir Dis, 2011, 34(5): 348-352. DOI: 10.3760/cma.j.issn.1001-0939.2011.05.010.