Clinical characteristics of coronavirus disease 2019 infected with Delta variant in Guangzhou:A real-world study
10.3760/cma.j.issn.1671-0282.2021.10.012
- VernacularTitle:广州Delta新冠病毒变异株感染的新型冠状病毒肺炎临床特征的真实世界研究
- Author:
Danwen ZHENG
1
;
Heng WENG
;
Yuntao LIU
;
Xin YIN
;
Jun ZHANG
;
Jian ZHANG
;
Luming CHEN
;
Yuanshen ZHOU
;
Jing ZENG
;
Yan CAI
;
Wanxin WEN
;
Qinghua ZHANG
;
Lanting TAO
;
Liangsheng SUN
;
Tianjin CAI
;
Weiliang WANG
;
Shubin CAI
;
Xindong QIN
;
Xiaofeng LIN
;
Xiaohua XU
;
Haimei ZOU
;
Qiaoli HUA
;
Peipei LU
;
Jingnan LIN
;
Kaiyuan ZHANG
;
Aihua OU
;
Jiqiang LI
;
Fang YAN
;
Xu ZOU
;
Lin LIN
;
Banghan DING
;
Jianwen GUO
;
Tiehe QIN
;
Yimin LI
;
Xiangdong GUAN
;
Xiaoneng MO
;
Zhongde ZHANG
Author Information
1. 广州中医药大学第二附属医院急诊科 510120
- Keywords:
Coronavirus disease 2019;
Delta variant;
Guangzhou;
Clinical characteristics;
A real-world study
- From:
Chinese Journal of Emergency Medicine
2021;30(10):1220-1228
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) infected with Delta variant, so as to provide further references for clinical diagnosis and treatment.Methods:A real-world study was conducted to analyze the characteristics of 166 COVID-19 patients infected with Delta variant at Guangzhou Eighth People’s Hospital, Guangzhou Medical University.Results:The study enrolled 5 asymptomatic cases, 123 non-severe cases (mild and moderate type), and 38 severe cases (severe and critical type). Among these patients, 69 (41.6%) were male and 97 (58.4%) were female, with a mean age of 47.0±23.5 years. Thirty-nine cases (23.5%) had received 1 or 2 doses of inactivated vaccine. The incidence of severe COVID-19 cases was 7.7% in 2-doses vaccinated patients, which was lower than that of 11.5% in 1-dose and 26.8% in unvaccinated patients. The proportion of severe cases in 2 dose-vaccinated patients was 7.7%, which was lower than that of 11.5% in 1-dose vaccinated patients and 26.8% in unvaccinated patients, but the difference was not significant ( P>0.05). The most common clinical symptom was fever (134 cases, 83.2%), and 39.1% of cases presented with high-grade fever (≥39 °C); other symptoms were cough, sputum, fatigue, and xerostomia. The proportion of fever in severe cases was significantly higher than that of non-severe cases (97.4% vs. 76.4%, P<0.01). Similarly, the proportion of severe cases with high peak temperature (≥39 ℃) () was also higher than that of non-severe cases (65.8% vs. 30.9%, P<0.01). The median minimal Cycle threshold (Ct) values of viral nucleic acid N gene and ORFlab gene were 20.3 and 21.5, respectively, and the minimum Ct values were 11.9 and 13.5, respectively. Within 48 h of admission, 9.0% of cases presented with decreased white blood cell counts, and 52.4% with decreased lymphocyte counts. The proportions of increased C-reactive protein, serum amyloid A, interleukin 6, and interleukin 10 were 32.5%, 57.4%, 65.3%, and 35.7%, respectively. The proportions of elevated C-reactive protein, serum amyloid A and interleukin-6 in severe cases were significantly higher than those in non-severe cases ( P<0.01). Logistic regression analysis showed that older age and higher peak temperature were associated with a higher likelihood of severe cases ( OR>3, 95% CI: 2-7, P<0.01). In terms of treatment, traditional Chinese medicine (TCM) was used in 97.6% of non-severe cases and 100% in severe cases. Other treatments included respiratory and nutritional support, immunotherapy (such as neutralizing antibodies and plasma of recovered patients). The median times from admission to progression to severe cases, of fever clearance, and of nucleic acid conversion were 5 days, 6 days and 19 days, respectively. No deaths were reported within 28 days. Conclusions:The symptoms of Delta variant infection in Guangzhou are characterized by a high proportion of fever, high peak temperature, long duration of fever, high viral load, a long time to nucleic acid conversion, and a high incidence of severe cases. The severe cases exhibit a higher percentage of elderly patients, a longer duration of fever and have a higher fever rate and a higher hyperthermia rate than non-severe cases. Age and hyperthermia are independent risk factors for progression to severe disease. The combination of TCM and Western medicine can control the progression of the disease effectively.
