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基础科研：Omicron感染者流行病学研究发表，揭示了真实世界中的病情严重程度

2021-12-22 生物探索 网络

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丹麦的研究显示，该国Omicron病例从12月4日开始，每天增长40%。这意味着不到两天就翻一番。

本文转载自“Hanson临床科研”微信公众号。

 

新冠病毒Omicron突变株正在全球掀起新一轮COVID-19疫情。流行病学研究是揭示Omicron突变株传染性、免疫逃逸和病情严重程度的基础，也是做好预防和疫苗接种部署的关键。

 

2021年12月16日，丹麦学者于Euro Surveill（欧洲检测）发表了785例丹麦Omicron感染者的流行病学特征，并与同期的Delta突变株感染者进行了比较，提供非常重要的信息。我们做一解读。

 

丹麦于2021年11月28日首次在南非返回的旅行者中发现了两名Omicron感染者，截止到12月9日，共登记了785名感染者。
需要说明的是，文章报道的是Omicron variant cases，而不是patients；我们在这里把cases翻译成感染者。需要首先区别研究对象是患者，还是感染者，才能在后面做出科学客观的理解，尤其是与既往认识做比较时。
丹麦报道的cases是全国检测数据，而不是医院的数据，也就是说，其cases的定义是RT-PCR或者全基因组测序（WGS）确定的Omicron感染者。需要特别提到的是，丹麦针对新冠的检测在全球亦处于领先位置，检测范围不仅仅是临床确诊病例，也包括确诊病例的密切接触者，还包括从12月1日开始对所有国际旅行者的检测。
所以丹麦的这项流行病学研究，展示的是Omicron感染者相对完整的情况；而这正是各国研究者急需知道的数据资料。
丹麦的研究显示，该国Omicron病例从12月4日开始，每天增长40%。这意味着不到两天就翻一番。
1、感染者的人口学特点
感染者年龄从2岁到95岁，年龄中位数为32岁；55%为男性；77%无旅行史，显示这组研究更接近社区感染病例。
2、Omicron感染者的疫苗接种史和既往新冠病毒感染史
这组Omicron感染者中，共有83.1%完全接种或者加强接种了疫苗，其中有76%接种了2剂疫苗，另有7.1%接种了第3剂疫苗。另有4.3%既往感染过新冠病毒。而Delta感染者中，则只有53.2%完全接种或者加强接种了疫苗。只有0.9%既往感染过新冠病毒。
 

3、Omicron感染者的病情
可以看到，报告了症状的Omicron感染者中，有73%有症状，27%无症状。Omicron感染者中，有1.2%住院，对比Delta感染者为1.5%；Omicron感染者中，有0.13%住ICU，对比Delta感染者为0.11%；Omicron感染者中，没有病例死亡，对比Delta感染者为0.07%。
 

Hanson解读：
这是针对Omicron突变株的第一项流行病学研究，尽管样本量小，但是丹麦做的检测非常完善，所以仍然提供了非常关键的资料。
(丹麦、英国、美国的疫情)
这组资料也继续验证着：
1、Omicron突变株有高于Delta突变株的免疫逃逸
83.1%的Omicron感染者既往接种过2剂或以上疫苗。不过这组数据，也让我们首次看得，原来Delta突变株的感染者也有50%接种过2剂剂以上疫苗。而丹麦已有77.5%的人群完全接种过疫苗，仍然未能阻挡新冠病毒Omicron突变株的蔓延。
2、Omicron的传染性极强
正如本文及上图展示的，一旦Omicron蔓延开来，不到2天就翻一番。
3、Omicron感染者1.2%住院，0.13%需要入住ICU
所以真实世界中Omicron感染者的症状确实不重。但是比之前毒株更弱吗？Delta感染者也仅有1.5%住院，0.11%需要住ICU。本文没有做统计学比较，我们猜想是由于作者考虑到样本量小，担心结论不可靠。
但这个结果已经显示，本组中Omicron突变株感染者和Delta突变株感染者的病情严重程度差不多；但不要忘了，Omicron组有更高比例的疫苗接种者和既往感染者。实际上，疫苗接种使得真实世界中COVID-19患者的病情普遍变轻。
4、我们有理由放松吗？
看到这个结果，个人肯定是更敢和家人一起外出过圣诞节了。但条件是：完全接种疫苗或者接种加强针；另外就是严格戴好口罩、保持距离。但政府和公卫管理者却更为焦虑和紧张。因为感染病例数增高，意味着全社会的住院和病死总数会增高。
更关键的是，根据另外一项挪威研究的病例报道，疫苗接种后Omicron感染者的常见症状已经完全不同，最常见的症状依次是：咳嗽（83%）、流涕（78%）、疲劳（74%）、咽痛（72%）和头痛（68%）。你看，和流感有区别吗？
（疫苗接种者）早期症状和流感区别不大的Omicron突变株，无疑会降低感染者就诊的意向和防疫的难度。
 
但是，和流感相近的Omicron感染者，是由于Omicron突变株吗？挪威研究的答复是“否”。目前挪威Omicron感染者的Delta突变株感染者的症状没有区别，都是由于疫苗接种，降低了病情的严重程度。
 
说了这么多，做一简单小结：
1、Omicron突变株传染性极强，一旦传播开，病例两天翻一番。所以，第一时间诊断和隔离，非常关键。
2、Omicron突变株对疫苗的免疫逃逸非常明显，但是Delta突变株也更加活跃。因为疫苗接种时间延长后，保护力就是降低嘛。所以，加强接种，非常关键。
3、好消息是，真实世界中发现，Omicron感染者的症状确实较之前轻（1.2%住院，0.13%入ICU），但是目前没有证据比Delta突变株感染者更轻（1.5%住院，0.11%入ICU）。目前的感染者症状都变轻了，主要是由于大部分感染者都完全接种了疫苗。
4、坏消息是，Omicron感染者的早期症状和流感真是很像，这也会增加防疫的难度。
所以，大家感染Omicron的几率明显增高；但是完全疫苗接种者的Omicron感染后症状相对来说不是如之前那么可怕，但和Delta感染者很可能仍旧差不多。希望对首篇Omicron感染者流行病学的研究，对您准确理解目前的疫情有些帮助。

End

参考资料：

[1]https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2021.26.50.2101146#html_fulltext

[2]https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2021.26.50.2101147#f1

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    2022-12-02 jiafufeng@yaho

    #CRO#

    0

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    2022-10-25 柳叶一刀

    #病情#

    0

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    2022-02-22 szhvet

    #基础科研#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1857980, encodeId=9c58185e980f1, content=<a href='/topic/show?id=3f48525849' target=_blank style='color:#2F92EE;'>#CRO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5258, encryptionId=3f48525849, topicName=CRO)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Fri Dec 02 17:37:16 CST 2022, time=2022-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1765166, encodeId=cda91e65166a7, content=<a href='/topic/show?id=df00e086653' target=_blank style='color:#2F92EE;'>#病情#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70866, encryptionId=df00e086653, topicName=病情)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Tue Oct 25 14:37:16 CST 2022, time=2022-10-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2043247, encodeId=36bf204324e21, content=<a href='/topic/show?id=a81742148e6' target=_blank style='color:#2F92EE;'>#基础科研#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42148, encryptionId=a81742148e6, topicName=基础科研)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec37461, createdName=szhvet, createdTime=Tue Feb 22 07:37:16 CST 2022, time=2022-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2084675, encodeId=56e920846e55e, content=<a href='/topic/show?id=61f411e013b' target=_blank style='color:#2F92EE;'>#Micro#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11701, encryptionId=61f411e013b, topicName=Micro)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d59291, createdName=xjy02, createdTime=Sat Nov 05 20:37:16 CST 2022, time=2022-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1295363, encodeId=44f9129536348, content=<a href='/topic/show?id=0425e2636b8' target=_blank style='color:#2F92EE;'>#真实世界#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72636, encryptionId=0425e2636b8, topicName=真实世界)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5b34252, createdName=chenshujs, createdTime=Fri Dec 24 00:37:16 CST 2021, time=2021-12-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1411408, encodeId=771714114084d, content=<a href='/topic/show?id=91e96538eee' target=_blank style='color:#2F92EE;'>#流行病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65387, encryptionId=91e96538eee, topicName=流行病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=xugumin, createdTime=Fri Dec 24 00:37:16 CST 2021, time=2021-12-24, status=1, ipAttribution=)]
    2022-11-05 xjy02

    #Micro#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1857980, encodeId=9c58185e980f1, content=<a href='/topic/show?id=3f48525849' target=_blank style='color:#2F92EE;'>#CRO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5258, encryptionId=3f48525849, topicName=CRO)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Fri Dec 02 17:37:16 CST 2022, time=2022-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1765166, encodeId=cda91e65166a7, content=<a href='/topic/show?id=df00e086653' target=_blank style='color:#2F92EE;'>#病情#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70866, encryptionId=df00e086653, topicName=病情)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Tue Oct 25 14:37:16 CST 2022, time=2022-10-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2043247, encodeId=36bf204324e21, content=<a href='/topic/show?id=a81742148e6' target=_blank style='color:#2F92EE;'>#基础科研#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42148, encryptionId=a81742148e6, topicName=基础科研)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec37461, createdName=szhvet, createdTime=Tue Feb 22 07:37:16 CST 2022, time=2022-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2084675, encodeId=56e920846e55e, content=<a href='/topic/show?id=61f411e013b' target=_blank style='color:#2F92EE;'>#Micro#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11701, encryptionId=61f411e013b, topicName=Micro)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d59291, createdName=xjy02, createdTime=Sat Nov 05 20:37:16 CST 2022, time=2022-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1295363, encodeId=44f9129536348, content=<a href='/topic/show?id=0425e2636b8' target=_blank style='color:#2F92EE;'>#真实世界#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72636, encryptionId=0425e2636b8, topicName=真实世界)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5b34252, createdName=chenshujs, createdTime=Fri Dec 24 00:37:16 CST 2021, time=2021-12-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1411408, encodeId=771714114084d, content=<a href='/topic/show?id=91e96538eee' target=_blank style='color:#2F92EE;'>#流行病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65387, encryptionId=91e96538eee, topicName=流行病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=xugumin, createdTime=Fri Dec 24 00:37:16 CST 2021, time=2021-12-24, status=1, ipAttribution=)]
    2021-12-24 chenshujs

    #真实世界#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1857980, encodeId=9c58185e980f1, content=<a href='/topic/show?id=3f48525849' target=_blank style='color:#2F92EE;'>#CRO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5258, encryptionId=3f48525849, topicName=CRO)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Fri Dec 02 17:37:16 CST 2022, time=2022-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1765166, encodeId=cda91e65166a7, content=<a href='/topic/show?id=df00e086653' target=_blank style='color:#2F92EE;'>#病情#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70866, encryptionId=df00e086653, topicName=病情)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Tue Oct 25 14:37:16 CST 2022, time=2022-10-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2043247, encodeId=36bf204324e21, content=<a href='/topic/show?id=a81742148e6' target=_blank style='color:#2F92EE;'>#基础科研#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42148, encryptionId=a81742148e6, topicName=基础科研)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec37461, createdName=szhvet, createdTime=Tue Feb 22 07:37:16 CST 2022, time=2022-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2084675, encodeId=56e920846e55e, content=<a href='/topic/show?id=61f411e013b' target=_blank style='color:#2F92EE;'>#Micro#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11701, encryptionId=61f411e013b, topicName=Micro)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d59291, createdName=xjy02, createdTime=Sat Nov 05 20:37:16 CST 2022, time=2022-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1295363, encodeId=44f9129536348, content=<a href='/topic/show?id=0425e2636b8' target=_blank style='color:#2F92EE;'>#真实世界#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72636, encryptionId=0425e2636b8, topicName=真实世界)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5b34252, createdName=chenshujs, createdTime=Fri Dec 24 00:37:16 CST 2021, time=2021-12-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1411408, encodeId=771714114084d, content=<a href='/topic/show?id=91e96538eee' target=_blank style='color:#2F92EE;'>#流行病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65387, encryptionId=91e96538eee, topicName=流行病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=xugumin, createdTime=Fri Dec 24 00:37:16 CST 2021, time=2021-12-24, status=1, ipAttribution=)]
    2021-12-24 xugumin

    #流行病#

    0

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