| Objectives: By exploring the pathogen spectrum of acute respiratory infection virus in Kashgar area,we are aiming at providing evidence for clinical diagnosis and treatment,and describing the epidemiological characteristics of the virus in Kashgar area.Analyze the general information and laboratory datas of patients with severe pneumonia,to provide reference for clinical diagnosis,treatment and prognosis of patients with severe pneumonia.Methods: Selected patients with acute respiratory infection who have admitted to the First People’s Hospital of Kashgar and other surrounding county hospitals,including Zepu County,Shule County,Shufu County,and other counties of Kashgar from November 2019 to October 2020,collected patients’ throat specimens.And real-time quantitative polymerse chain reaction(RT-q PCR)was used to detect six kind of viruses,including : Influenza A virus(Flu A),Influenza B virus(Flu B),respiratory syncytial virus(RSV),adenovirus(ADV),Human parainfluenza virus(HPIVs),Human Enterovirus,(HEV).We analyzed the positive rate of the virus among different regions and seasons,to draw the spectrum of the virus of acute respiratory infections in this region.We aslo collected and analyzed the related clinical and laboratory examination databases to establish a predictive model of severe pneumonia.Results:1.From November 2019 to October 2020,1873 cases of acute respiratory infections in Kashgar were detected,and the overall positive rate was 24.13%.The positive rates of the six viruses in descending order were: Flu A(8.38%),RSV(7.85%),HEV(4.97%),ADV(3.90%),HPIVs(1.44%),Flu B(0.48%).2.Among the 1873 ARI cases,463 were adults(≥14 years old)and 1410 were children(< 14 years old).There was no gender difference in virus distribution(P > 0.05).3.The positive rate of six kind of virus in children(26.88%)was higher than that in adults(15.77%).RSV has the highest positive rate in children(9.50%)and Flu A has the highest positive rate in adults(9.07%).The composition of pathogens was different in different age groups.4.The spread of acute respiratory virus presented certain seasonal characteristics.The peak season was winter.5.In Kashgar,Flu A is the virus with the highest positive rate in most region in Kashgar area,but RSV was the most common virus in Yuepuhu county,Bachu county and Ta county,while HEV was the most common virus in Zepu county.6.The highest positive rate was Flu A(9.02% and 6.05%)in Uygur and Han.7.In univariate analysis,there were 7 factors which were ralated the severity of pneumonia,including nationality,age,presence of congenital heart disease,WBC count,NE%,LY%,PCT level,but it was not related to other basic diseases,such as anemia,asthma and malnutrition,and CRP level,ESR level and different types of virus infection.In multivariate regression analysis,there were four risk factors of severe pneumonia,including WBC,NE%,whether were less than3 years old,congenital heart disease.8.Finally,the severe pneumonia prediction model was established based on whether the patients had congenital heart disease,whether they were less than 3 years old,WBC and NE%.AUC was 0.741(95% CI: 0.685-0.797),Youden index was 0.410,sensitivity was 0.53,specificity was 0.88.This model has certain predictive value for the diagnosis of severe pneumonia.Conclusion: 1.Flu A and RSV were the common pathogens of acute respiratory tract infection in Kashgar area.2.The pathogen spectrum of respiratory tract was different among different ages and seasons.Total respiratory virus positive rate: higher in children than adults,higher in winter than other seasons.3.The prediction model combined with age,WBC,NE% and the presence of congenital heart disease has a certain reference value for the diagnosis and prediction of severe pneumonia. |
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