EClinical Medicine:全球!钟南山团队首次描绘德尔塔变异株的完整传播链

2021-09-20 生物探索 生物探索

南京、扬州的疫情还没过去多久,这几天福建疫情又刷爆了热搜,让人们稍微平静的心再次悬了起来。经检测,此次疫情仍是因德尔塔变异毒株感染引起的,那么德尔塔变异株的完整传播链到底是怎样的?

南京、扬州的疫情还没过去多久,这几天福建疫情又刷爆了热搜,让人们稍微平静的心再次悬了起来。经检测,此次疫情仍是因德尔塔变异毒株感染引起的,那么德尔塔变异株的完整传播链到底是怎样的?

近日,钟南山院士联合广州医科大学附属市八医院的相关科研学家给出了答案,他们在《柳叶刀》子刊《EClinical Medicine》发表了一篇题为“Transmission, viral kinetics and clinical characteristics of theemergent SARS-CoV-2 Delta VOC in Guangzhou, China”的文章,将流行病学和病毒基因组测序技术相结合,针对此前德尔塔病毒在广州引起的“5·21新冠肺炎疫情”进行深入分析,首次追踪并完整报道了这起疫情的清晰传播链,并结合临床资源,多方位描绘了这次疫情中感染者的临床特征及病毒的动力学特征。

据悉,此次“5·21新冠肺炎疫情”的起因是一名75岁女性因意外暴露感染,并通过密切的家庭接触或聚餐又感染其他3人,然后该变异病毒传播6代,致使159人感染。此外,研究人员观察到,该疫情中病毒的传播途径主要是通过直接和间接近距离接触,其中30.8%的感染者是用餐传播,30.13%的感染者是家庭接触传播、18.59%的感染者是社区传播、19.87%的感染者是包括工作和社交接触在内的其他传播途径。

为了了解德尔塔变异毒株的主要特点,研究人员提取了2021年5月21日至6月18日期间七个传播代的159例德尔塔感染病例相关的流行病学和临床信息,并将病毒载量动力学和临床特征与广州第八人民医院2020年收治的野生型感染队列进行多方位分析比较。

研究结果显示,与普通新冠毒株相比,德尔塔变异株的潜伏期短,传播速度快,在10天内可传播4代,中位潜伏期只有4.7天,其中最快的代际传播不超过24小时。不仅如此,德尔塔变异株感染者的病毒载量也更高,感染后核酸转阴的时间明显延长。

除此之外,感染德尔塔变异株是预测病情转为危重症的危险因素,在60岁及以上老年患者中,感染德尔塔变异株出现危重症的风险是感染野生株的1.65倍,发展为危重症的速度比野生株快2.98倍。这说明快速追踪、隔离以及时发现病毒感染者,对重点场所实施及时管控和在特殊情况下实施局部地区全员核酸筛查均非常重要。

(图注:德尔塔毒株的流行病学传播网络)

总而言之,这项研究揭示了德尔塔变异毒株具有潜伏期短、传播速度快、病毒载量高、核酸转阴时间长、更易发展为危重症的特点。但值得注意的是,这里的一项“潜伏期”数据似乎与近日发生的“莆田疫情”不符,据了解,莆田疫情源头疑似出现了“38 天”的潜伏期。为此,有专家分析可能有3种原因。

其一是检测结果出现“假阴性”。但德尔塔毒株病毒载量较高,理论上应该可以轻松检测出来,出现这种现象的概率极小。而另一种推测是患者出现了所谓的超长潜伏期,相关专家表示,不排除个别病例存在超长潜伏期的可能性。超长潜伏期或者长期病毒携带者在其他一些病毒感染中曾被发现过,比如在脊髓灰质炎中,有些免疫缺陷患者感染后会长期排毒,甚至长达数年。因此尽管还不清楚新型冠状病毒是否也能在特殊人群中长期携带,但这种风险也需要考虑。此外,还有最后一种可能就是隔离过程中的暴露感染。

对此,相关专家表示,“外防输入、内防反弹”的任务依然艰巨,防控须臾不可放松,没有发生疫情时关键在“防”,发生疫情后处置措施要“快”要“细”,核酸检测、流调溯源、风控管理、场所和物资准备等每一个环节都要责任到人、精准到位,只有做好“万无一失”的准备,才能避免“一失万无”的后果。

原始出处:

Yaping Wang, et al. Transmission, viral kinetics and clinical characteristics of the emergent SARS-CoV-2 Delta VOC in Guangzhou, China. EClinical Medicine, 2021.

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    2022-07-06 jeanqiuqiu
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    2021-09-22 zll0628
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    2021-09-21 ms6000000013415337

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    2021-09-21 与狼共舞

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    2021-09-21 法荣

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