Discussion
Pneumonia patients are a common disease among hospitalized patients. In
the context of the COVID-19 pandemic, our study is the first to analyze
changes in virus detection in patients with pneumonia post-COVID-19. We
found that the detection of post-COVID-19 virus and influenza virus had
decreased 23.3% and 18.3%,respectively,Although the virus testing rate
is gradually increasing.And the need for invasive ventilation support in
post-COVID-19 patients had increased.This has implications for the
prevention of influenza virus post-COVID-19 and the selection of
appropriate treatment.
We have the following conclusions that the detection of influenza
viruses decreased post-COVID-19, especially InfAH1N1(2009),Influenza
virus accounted for an important part of virus detection before COVID-19
occurred.In apopulation-based study[4] of
community-acquired pneumonia in 2017, The viruses are dominated by
rhinovirus,influenza virus . And from January to July 2016, West China
Hospital conducted viral nucleic acid testing for outpatient and
inpatient patients of all age groups, indicating that the highest
detection rate of a single viral nucleic acid detection was rhinovirus
and alpha-fluid H1N1 2009.The possible reasons for this result are
similar to the previous epidemics of other influenza viruse,the virus
transmission law of China (H1N1) influenza pandemic in 2009 and the SIRD
virus transmission model of prevention and control strategy show that
school suspension, the factory stopped production,restricting free flow
of population, expanding the scope of suspected cases,vaccination and
other are effective measures to control the outbreak.In China, regional
and local governments, including Hubei, have strengthened the prevention
measures since January 2020 to curb the spread of
COVID-19[5]. Many cities in Hubei province have
been locked down, and many measures have been implemented, such as
tracking close contacts, isolating infected people, and promoting social
consensus on self-protection (such as wearing
masks[6] in public places, minimum social
distancing), so the effect of the full implementation of preventive
measures is also obvious.
In our study, the positive microbiological result was low, from 34.4%
pre-COVID-19, but only 24% post-COVID-19,This is similar to HAESSLER
S’s study[7] ;and the microbe delivery rate
decreased, probably because there are more options for other pathogen
testing methods.
There are limitations regarding this study.First, this study is a
single-center descriptive study, a center can only represent the
epidemic of the region at that time, can not represent the whole of
China or can be extended to other environments, because the transmission
of respiratory pathogens according to different geographical area, time
and other factors, when conditions allow, we expect to complete the
national multi-center study.Secondly, all the data came from the
retrospective case data, but we went through the rigorous screening of
the data to ensure the data rigor.Second, Our study into the detection
of the virus for positive method for 13 viral nucleic acid testing
programs, which other hospitals may not have, and the study detection
method is conducted in our hospital in recent years, so in our table 1,
after the new crown the inspection rate is increased, so we obtained the
virus detection positive rate of the total data early some years of data
may be lower. However, according to some literature, the results on the
etiology of pre-COVID-19 are basically consistent with some
studies.Third, the missing vaccine information that the patient had had
had an impact on the baseline information, so we cannot rule out a viral
infection after the patient had been vaccinated.In conclusion, this
study shows that we should deinject the vaccine according to the
prevalence of the etiology at each stage of the CAP, reducing the waste
of medical resources.
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