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충남 코로나바이러스감염증-19 확진 일부 환자의 임상정보 기반 중증도별 특성 분석

Clinical Information Analysis of Characteristics of COVID-19 Patients by Severity in Chungnam Province, Korea

주간 건강과 질병 2021년 14권 3호 p.104 ~ 112
조다혜, 임지애, 서정은, 천영희, Jeong Seung-Hee, Kang Gi-Seok, 최동권, 김진아, 신손문,
소속 상세정보
조다혜 ( Jo Da-Hye ) - Chungnam Center for Infectious Diseases Control and Prevention
임지애 ( Lim Ji-Ae ) - Chungnam Center for Infectious Diseases Control and Prevention
서정은 ( Seo Jeung-Eun ) - Chungnam Center for Infectious Diseases Control and Prevention
천영희 ( Cheon Young-Hee ) - Chungnam Center for Infectious Diseases Control and Prevention
 ( Jeong Seung-Hee ) - Chungnam Center for Infectious Diseases Control and Prevention
 ( Kang Gi-Seok ) - Chungnam Center for Infectious Diseases Control and Prevention
최동권 ( Choi Dong-Kwon ) - Chungnam Center for Infectious Diseases Control and Prevention
김진아 ( Kim Jin-A ) - Chungnam Center for Infectious Diseases Control and Prevention
신손문 ( Shin Son-Moon ) - Chungnam Center for Infectious Diseases Control and Prevention

Abstract

본 연구는 충남의 1차 유행 기간인 2020년 2월 18일부터 7월 27일까지 발생한 확진 환자 189명 중 결측이 있던 14명을 제외한 총 175명의 확진환자를 대상으로 하였으며, 의료기관 조사를 통해 수집된 임상정보 및 초기 기초역학조사서를 활용하여 코로나19 확진 환자의 중증도에 영향을 미치는 위험요인을 파악한 연구이다.
확진 환자의 78.5%는 경증, 21.5%는 위·중증으로 분류되었으며, 기저질환은 고혈압(41.0%), 고지혈증(17.9%), 당뇨(12.8%), 암치료(10.3%), 기타(7.7%), 호흡기질환(5.1%) 및 갑상선질환(5.1%) 순이다. 중증도별 기초역학조사서 분석 결과 위·중증 위험도는 남자 3.69배, 65세 이상 12.3배, 초기 임상증상이 폐렴일 경우 14.0배, 기저질환자 5.23배 높았다. 또한 RT-PCR 검사 결과 코로나19 확진 당시 E gene 및 RdRp gene 모두 평균 CT값은 경증 환자보다 위·중증 환자에서 통계적으로 유의하게 낮았으며, 평균 재원일은 경증 환자 19.06일, 위·중증 환자 24.32일로 나타났다.
충남은 12월 16일 현재까지 지역사회 내 빈번한 집단발생 양상을 보이고 있으며, 확진 환자도 계속 증가하는 추세이다. 향후 효율적인 의료자원 활용을 위해 본 연구 결과를 중증도 분류 기준 수립에 활용할 수 있을 것이다.

Chungnam, a province in Korea, had its first confirmed case of coronavirus disease-19 (COVID-19) infection since February 2020. It has observed a rapid growth in infections that continue to cause shortages of hospital resources such as hospital beds in the region. This study was conducted to identify the risk factors affecting the severity of coronavirus disease-19 (COVID-19) with the aim of better responding to future pandemics and more wisely and effectively allocating resources. Data came from both clinical records through healthcare facilities and primary epidemiological investigations in Chungnam, a province in Korea, during the initial phase of the COVID-19 pandemic. The data included 175 patients who tested positive for COVID-19 out of 189 confirmed cases from February 18 to July 27, 2020. Of the total confirmed patients, 78.5% were patients with mild symptoms while 21.5% were patients with moderate or severe symptoms. The underlying medical conditions were hypertension (41.0%), hyperlipidemia (17.9%), diabetes (12.8%), cancer (10.3%), other (7.7%), respiratory disease (5.1%), and thyroid disease (5.1%). The results from clinical records showed that the risks of moderate or severe levels of severity were 3.69 times higher among men, 12.3 times higher among patients over 65 years old, 14 times higher among patients with pneumonia, and 5.23 times higher among patients with underlying medical conditions. According to the reverse transcription polymerase chain reaction (RT-PCR) test from the epidemiological investigations, the mean cycle threshold (CT) values for the envelope (E) gene (rSARS-CoV-DeltaE) and the RdRp gene, the laboratory test for COVID-19, were statistically significantly lower in patients with moderate and severe symptoms than for those with mild symptoms. The average hospital stay among patients with mild symptoms and moderate and severe symptoms was 19.06 days and 24.32 days, respectively. Given that Chungnam has seen an increase in local outbreaks as of December 16, 2020 and that the number of patients who tested positive continues to rise, it is critical that epidemiologists consider the results of this study, particularly when developing classification criteria by severity.

키워드

코로나바이러스감염증-19(코로나19); 임상증상; 임상중증도; 기초역학
2019 Novel Coronavirus (2019-nCoV); Coronavirus Disease-19 (COVID-19); Symptoms; Clinical Severity; Epidemiological Investigations

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