在DENV-4临床表现中的范式转变:从2023年Lincang爆发的肺炎症状的观点
Bo Zhang1, Fuying Guo2, Peng Wang3
1School of Environmental Science and Engineering, Hainan University, Haikou, China.
下呼吸道症状在2023年爆发期间的登革热病毒血清型4 (DENV-4) 感染中很常见. 这些肺部发现与严重登革热有关,并表明例行呼吸系统监测对于患者护理至关重要.
科学领域:
- 传染性疾病 传染性疾病
- 肺部病理学 肺部病理学
- 病毒学 病毒学
背景情况:
- 2023年在中国林康市爆发的登革热病毒4型 (DENV-4) 疫情揭示了显著的下呼吸道干预,这种表现通常不会在登革热描述中突出.
- 这一观察促使人们对DENV-4爆发期间呼吸系统症状的流行率和特征进行调查.
研究的目的:
- 调查DENV-4感染住院患者下呼吸道感染的频率,临床表现和结果.
- 探索呼吸系统症状与登革热病的严重程度之间的关联.
- 为了确定严重登革热的预测因素,包括呼吸道表现.
主要方法:
- 对147个经RT-PCR确认的DENV-4病例进行了回顾性分析.
- 实施一个分层的呼吸评估方案,包括每天的症状查,脉冲氧计,胸部放射,肺部超声波和严重病例的CT扫描.
- 利用EBICglasso网络分析来评估症状结构和后勤回归,以确定严重登革热的预测因素.
主要成果:
- 31.3%的患者有肺部症状,下呼吸道感染 (28.6%) 和咳 (25.9%) 是最常见的.
- 在单变量分析 (OR 2.91) 中,下呼吸道感染与严重登革热有关. 血小板减少 (AOR 3.06) 和肝功能低下 (AOR 3.82) 独立地与严重的登革热有关.
- 网络分析揭示了呼吸系统症状的凝聚性集群,表明整体临床范围内的强有力的条件关联. 随着支持性护理,症状在平均7天内消失.
结论:
- 下呼吸道表现在 I 基因型 DENV-4 感染中很常见,并形成一个连贯的症状网络.
- 这些呼吸道症状与登革热的严重程度有关,突显了综合呼吸道监测的必要性.
- 这些发现支持将呼吸道查,脉冲氧计和逐步成像技术常规纳入登革热护理途径,等待多中心研究中的验证.
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