Lancet:奥密克戎症状及持续时间已大不相同!多是上呼吸道症状,症状持续时间缩短,但喉咙痛增至70.5%!

2022-04-09 四五七 MedSci原创

2022年4月7日,柳叶刀杂志发布了一项来自英国的大型研究,揭示了感染奥密克戎的疫苗接种人群(至少接种两针)出现的症状、症状持续时间、住院率和之前的毒株相比有何不同。

在过去20天(3月18日- 4月9日),全国累计本土确诊病例38051例,无症状感染者190964例,总计229015例,而自2019年武汉疫情的整整两年,全国累计确诊病例也才突破1万。

当下疫情最严重的上海,感染人数仍处于高位,每日新增感染人数激增至2万,规模甚至超过了当年的武汉,而周围省市也面临着外溢风险。

我们都知道奥密克戎传播性强、症状轻,然而至今没有一篇研究详细报道感染奥密克戎后会出什么样的症状、症状持续时间、和之前的病毒株相比有何不同,特别是在大部分人已经接种了新冠疫苗的情况下。

2022年4月7日,柳叶刀杂志发布了一项来自英国的大型研究,揭示了感染奥密克戎的疫苗接种人群(至少接种两针)出现的症状、症状持续时间、住院率和之前的毒株相比有何不同,希望能为针对奥密克戎的公共卫生政策的制定提供参考。

图片

这项研究的数据来自英国的一款名为ZOE的专门收集用户新冠感染信息的手机APP,在2021年6月至2022年1月期间,一共有63000多名16-99岁的人在APP上提交了他们感染新冠后出现的症状。

研究者将2021年6月1日至2021年11月27的感染病例默认为德尔塔感染,这一时间段英国德尔塔毒株的流行率超过70%,而2021年12月20日至2022年1月17日的感染病例为奥密克戎感染,此时奥密克戎基本取代德尔塔成为主流毒株。

奥密克戎感染者与德尔塔感染者按年龄、性别、疫苗接种情况1:1配对,该研究最终纳入奥密克戎感染者和德尔塔感染者各4990名。

根据报告结果,奥密克戎患者最经常出现的症状有:流涕(76.5%),头痛(74.4%),喉咙痛(70.5%),打喷嚏(63.0%),持续性咳嗽(49.8%),声音嘶哑(42.6%)。

和德尔塔感染的症状相比,奥密克戎感染主要有两个特点:

一,嗅觉丧失的情况减少了,仅有17%的奥密克戎感染者出现嗅觉丧失,而这一比例在德尔塔感染者中为52.7%。

二,喉咙痛、声音嘶哑的情况明显变多了,奥密克戎患者出现喉咙痛、声音嘶哑的风险和德尔塔感染者相比,分别提高了55%(OR  1·55,  95%  CI  1·43–1·69  [p<0·001])和24%(1·24,  1·14–1·34  [p<0·001])。

万幸的是,一些使人虚弱的症状,比如脑雾、眼睛酸痛、眩晕、高热等,在奥密克戎感染者身上出现的概率和之前的毒株相比也下降了,这也符合我们对奥密克戎症状轻的判断。

在住院率上,接种了2针以上疫苗的奥密克戎感染者,在新冠检测结果阳性的前后7天内的住院率为1.9%,而同样接种了疫苗的德尔塔患者住院率为2.6%,也就是说,感染奥密克戎后的住院风险和德尔塔相比,下降了25%(OR 0·75)。

从症状出现到消失,德尔塔感染者平均经历了8.89天,而奥密克戎感染者则为6.87天,症状持续时间少了将近2天。

在接种了3针疫苗的感染者身上,这种差距则更明显,接种加强针的奥密克戎患者症状持续时间平均为4.40天,而德尔塔感染者为7.71天,相差3.3天。

整体而言,接种了两针以上疫苗的奥密克戎感染者和德尔塔感染者相比,在一周内恢复的概率是后者的2倍以上(OR 2.49 95% CI 2·10–2·95),也说明了新冠疫苗应接尽接是十分必要的。 

图片

图注:整体上、接种了2针疫苗和接种了3针疫苗的德尔塔和奥密克戎感染者症状持续时间

研究者还提到:这项研究覆盖的时间虽然在奥密克戎BA.2变异株席卷全球之前,但是从APP最新收集的数据来看,BA.2的症状和BA.1并没有变化。

这是目前关于奥密克戎与德尔塔感染症状及症状持续时间对比的,样本最大、且经过同行评审的研究,证明奥密克戎和之前的毒株相比,感染症状已经发生改变,感染者恢复时间变短,也就意味着感染者的传染期可能会更短。

参考文献

Symptom prevalence, duration, and risk of hospital admission in individuals infected with SARS-CoV-2 during periods of omicron and delta variant dominance: a prospective observational study from the ZOE COVID Study DOI:https://doi.org/10.1016/S0140-6736(22)00327-0

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    2023-01-10 xzw122
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createdName=ms倩, createdTime=Sun Apr 10 07:49:17 CST 2022, time=2022-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1282583, encodeId=4b57128258351, content=<a href='/topic/show?id=700239e0772' target=_blank style='color:#2F92EE;'>#呼吸道#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39707, encryptionId=700239e0772, topicName=呼吸道)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2e94174, createdName=zhmscau, createdTime=Mon Apr 11 13:08:39 CST 2022, time=2022-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1503695, encodeId=c1e81503695a7, content=<a href='/topic/show?id=4f215634296' target=_blank style='color:#2F92EE;'>#持续时间#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56342, encryptionId=4f215634296, 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=赛华佗, createdTime=Sun Apr 10 07:52:15 CST 2022, time=2022-04-10, status=1, ipAttribution=)]
    2022-11-13 howi
  4. 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    2022-04-16 ms5000000518166734

    学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习学习

    0

  5. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=赛华佗, createdTime=Sun Apr 10 07:52:15 CST 2022, time=2022-04-10, status=1, ipAttribution=)]
    2022-04-10 ms3000000880550052

    学习

    0

  6. 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createdName=ms倩, createdTime=Sun Apr 10 07:49:17 CST 2022, time=2022-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1282583, encodeId=4b57128258351, content=<a href='/topic/show?id=700239e0772' target=_blank style='color:#2F92EE;'>#呼吸道#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39707, encryptionId=700239e0772, topicName=呼吸道)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2e94174, createdName=zhmscau, createdTime=Mon Apr 11 13:08:39 CST 2022, time=2022-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1503695, encodeId=c1e81503695a7, content=<a href='/topic/show?id=4f215634296' target=_blank style='color:#2F92EE;'>#持续时间#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56342, encryptionId=4f215634296, topicName=持续时间)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=13e29684821, createdName=zhwj, createdTime=Mon Apr 11 13:08:39 CST 2022, time=2022-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1209930, encodeId=440a120993033, content=谢谢分享,转发到**朋友圈怎么打不开。, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=1, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210703/5d4678ea36e146e4a5cc97581f3c5cfd/8cabb730d8f34a9db82e92bfd1b67ffc.jpg, createdBy=82281799739, createdName=ms2955258463467712, createdTime=Sat Apr 09 23:59:45 CST 2022, time=2022-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1209965, encodeId=bbc512099656b, content=接种加强针的奥密克戎患者症状持续时间平均为4.40天,未接种过加强针是7天症状持续,与感冒是相似的, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=赛华佗, createdTime=Sun Apr 10 07:52:15 CST 2022, time=2022-04-10, status=1, ipAttribution=)]
    2022-04-10 ms倩

    学习了

    0

  7. 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createdName=ms倩, createdTime=Sun Apr 10 07:49:17 CST 2022, time=2022-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1282583, encodeId=4b57128258351, content=<a href='/topic/show?id=700239e0772' target=_blank style='color:#2F92EE;'>#呼吸道#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39707, encryptionId=700239e0772, topicName=呼吸道)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2e94174, createdName=zhmscau, createdTime=Mon Apr 11 13:08:39 CST 2022, time=2022-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1503695, encodeId=c1e81503695a7, content=<a href='/topic/show?id=4f215634296' target=_blank style='color:#2F92EE;'>#持续时间#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56342, encryptionId=4f215634296, topicName=持续时间)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=13e29684821, createdName=zhwj, createdTime=Mon Apr 11 13:08:39 CST 2022, time=2022-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1209930, encodeId=440a120993033, content=谢谢分享,转发到**朋友圈怎么打不开。, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=1, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210703/5d4678ea36e146e4a5cc97581f3c5cfd/8cabb730d8f34a9db82e92bfd1b67ffc.jpg, createdBy=82281799739, createdName=ms2955258463467712, createdTime=Sat Apr 09 23:59:45 CST 2022, time=2022-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1209965, encodeId=bbc512099656b, content=接种加强针的奥密克戎患者症状持续时间平均为4.40天,未接种过加强针是7天症状持续,与感冒是相似的, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=赛华佗, createdTime=Sun Apr 10 07:52:15 CST 2022, time=2022-04-10, status=1, ipAttribution=)]
    2022-04-11 zhmscau
  8. 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createdName=ms倩, createdTime=Sun Apr 10 07:49:17 CST 2022, time=2022-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1282583, encodeId=4b57128258351, content=<a href='/topic/show?id=700239e0772' target=_blank style='color:#2F92EE;'>#呼吸道#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39707, encryptionId=700239e0772, topicName=呼吸道)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2e94174, createdName=zhmscau, createdTime=Mon Apr 11 13:08:39 CST 2022, time=2022-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1503695, encodeId=c1e81503695a7, content=<a href='/topic/show?id=4f215634296' target=_blank style='color:#2F92EE;'>#持续时间#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56342, encryptionId=4f215634296, topicName=持续时间)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=13e29684821, createdName=zhwj, createdTime=Mon Apr 11 13:08:39 CST 2022, time=2022-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1209930, encodeId=440a120993033, content=谢谢分享,转发到**朋友圈怎么打不开。, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=1, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210703/5d4678ea36e146e4a5cc97581f3c5cfd/8cabb730d8f34a9db82e92bfd1b67ffc.jpg, createdBy=82281799739, createdName=ms2955258463467712, createdTime=Sat Apr 09 23:59:45 CST 2022, time=2022-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1209965, encodeId=bbc512099656b, content=接种加强针的奥密克戎患者症状持续时间平均为4.40天,未接种过加强针是7天症状持续,与感冒是相似的, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=赛华佗, createdTime=Sun Apr 10 07:52:15 CST 2022, time=2022-04-10, status=1, ipAttribution=)]
    2022-04-11 zhwj
  9. 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createdName=ms倩, createdTime=Sun Apr 10 07:49:17 CST 2022, time=2022-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1282583, encodeId=4b57128258351, content=<a href='/topic/show?id=700239e0772' target=_blank style='color:#2F92EE;'>#呼吸道#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39707, encryptionId=700239e0772, topicName=呼吸道)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2e94174, createdName=zhmscau, createdTime=Mon Apr 11 13:08:39 CST 2022, time=2022-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1503695, encodeId=c1e81503695a7, content=<a href='/topic/show?id=4f215634296' target=_blank style='color:#2F92EE;'>#持续时间#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56342, encryptionId=4f215634296, topicName=持续时间)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=13e29684821, createdName=zhwj, createdTime=Mon Apr 11 13:08:39 CST 2022, time=2022-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1209930, encodeId=440a120993033, content=谢谢分享,转发到**朋友圈怎么打不开。, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=1, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210703/5d4678ea36e146e4a5cc97581f3c5cfd/8cabb730d8f34a9db82e92bfd1b67ffc.jpg, createdBy=82281799739, createdName=ms2955258463467712, createdTime=Sat Apr 09 23:59:45 CST 2022, time=2022-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1209965, encodeId=bbc512099656b, content=接种加强针的奥密克戎患者症状持续时间平均为4.40天,未接种过加强针是7天症状持续,与感冒是相似的, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=赛华佗, createdTime=Sun Apr 10 07:52:15 CST 2022, time=2022-04-10, status=1, ipAttribution=)]
    2022-04-09 ms2955258463467712

    谢谢分享,转发到**朋友圈怎么打不开。

    1

    展开1条回复
  10. 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createdName=ms倩, createdTime=Sun Apr 10 07:49:17 CST 2022, time=2022-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1282583, encodeId=4b57128258351, content=<a href='/topic/show?id=700239e0772' target=_blank style='color:#2F92EE;'>#呼吸道#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39707, encryptionId=700239e0772, topicName=呼吸道)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2e94174, createdName=zhmscau, createdTime=Mon Apr 11 13:08:39 CST 2022, time=2022-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1503695, encodeId=c1e81503695a7, content=<a href='/topic/show?id=4f215634296' target=_blank style='color:#2F92EE;'>#持续时间#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56342, encryptionId=4f215634296, topicName=持续时间)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=13e29684821, createdName=zhwj, createdTime=Mon Apr 11 13:08:39 CST 2022, time=2022-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1209930, encodeId=440a120993033, content=谢谢分享,转发到**朋友圈怎么打不开。, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=1, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210703/5d4678ea36e146e4a5cc97581f3c5cfd/8cabb730d8f34a9db82e92bfd1b67ffc.jpg, createdBy=82281799739, createdName=ms2955258463467712, createdTime=Sat Apr 09 23:59:45 CST 2022, time=2022-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1209965, encodeId=bbc512099656b, content=接种加强针的奥密克戎患者症状持续时间平均为4.40天,未接种过加强针是7天症状持续,与感冒是相似的, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=赛华佗, createdTime=Sun Apr 10 07:52:15 CST 2022, time=2022-04-10, status=1, ipAttribution=)]
    2022-04-10 赛华佗

    接种加强针的奥密克戎患者症状持续时间平均为4.40天,未接种过加强针是7天症状持续,与感冒是相似的

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