基于系统综述的新型冠状病毒肺炎与2009年H1N1流感大流行基本传染数研究

陈嘉敏; 邱增钊; 钟舒怡; 文思敏; 舒跃龙

引用本文: 陈嘉敏, 邱增钊, 钟舒怡, 文思敏, 舒跃龙. 基于系统综述的COVID-19与2009年H1N1流感大流行基本传染数研究[J]. 疾病监测. shu

Citation: Jiamin Chen, Zengzhao Qiu, Shuyi Zhong, Simin Wen and yuelong Shu. Study of R0 of COVID-19 and pandemic influenza A (H1N1) 2009 based on systematic review[J]. Disease Surveillance. shu

基于系统综述的新型冠状病毒肺炎与2009年H1N1流感大流行基本传染数研究

陈嘉敏 ^, ,
邱增钊 ^, ,
钟舒怡 ,
文思敏 ,
舒跃龙 ^{,

,}

中山大学公共卫生学院（深圳），广东广州 510006

作者简介: 陈嘉敏，女，广东省云浮市人，硕士研究生，主要从事病原与传染病防控研究工作，Email：chenjm257@mail2.sysu.edu.cn;邱增钊，男，广东省梅州市人，硕士研究生，主要从事病原与传染病防控研究工作，Email：qiuzzh5@mail2.sysu.edu.cn;

通信作者: 舒跃龙, shuylong@mail.sysu.edu.cn

基金项目: 深圳市科技计划项目（No.KQTD20180411143323605）

摘要: 目的通过系统综述方法，基于基本传染数（R₀）比较新型冠状病毒肺炎（COVID-19）与2009年 H1N1流感大流行的传播能力。方法通过检索中国知网、万方数据库、维普数据库、PubMed、Embase、Web of Science、BioRxiv和MedRxiv数据库，2名审查员对COVID-19和2009年H1N1流感大流行的R₀相关研究进行独立筛选、提取数据和计算，并对提取的2次疫情的R₀进行系统性总结和比较。结果共纳入164篇文献（包括54篇2009年甲型H1N1流感大流行相关文章和110篇COVID-19相关文章）。 COVID-19在世界流行的R₀中位数为2.860（四分位数范围IQR: 2.350～3.560），高于2009年H1N1流感大流行的R₀中位数（1.508，IQR: 1.336～1.836）。中国COVID-19的R₀中位数为2.930（IQR: 2.215～3.453），施行严格交通管制前COVID-19的R₀中位数为3.430（IQR: 2.500～4.710），高于之后的2.500（IQR: 1.673～3.030）。结论COVID-19的传播能力强于2009年甲型H1N1流感。中国采取严格交通管制措施后，能够减缓COVID-19的传播。

关键词:

English

Study of R₀ of COVID-19 and pandemic influenza A (H1N1) 2009 based on systematic review

School of Public Health, Sun Yat-sen University, Guangzhou 510006, Guangdong, China

Corresponding author: Yuelong Shu, shuylong@mail.sysu.edu.cn

Received Date: 2020-08-03
Available Online: 2020-12-30
Fund Project: This study was supported by Shenzhen Science and Technology Program (No.KQTD20180411143323605)

Abstract: ObjectiveThe compare transmission efficiency of coronavirus disease 2019 (COVID-19) and influenza A (H1N1) pdm09 by a systematic review based on R₀ calculation.MethodsWe conducted a literature retrieval by using the databases of CNKI, WanFang Data, VIP, PubMed, Embase, Web of Science, BioRxiv and MedRxiv for the research of COVID-19 and influenza A (H1N1) pdm09. Two reviewers independently screened the literatures, extracted and calculated related data and systematically compared the R₀ of the two outbreaks.ResultsA total of 164 papers were included (54 about influenza A (H1N1) pdm09 and 110 about COVID-19). The median R₀ of COVID-19 [2.860 (IQR: 2.350−3.560)] was higher than that of influenza A (H1N1) pdm09 [1.508 (IQR: 1.336−1.836)] in the world. In China, the median R₀ of COVID-19 was 2.930 (IQR: 2.215–3.453) and the median R₀ of COVID-19 before the lockdown of Wuhan [3.430 (IQR: 2.500−4.710)] was higher than that after the lockdown of Wuhan [2.500 (IQR: 1.673−3.030)].ConclusionThe transmission efficiency of COVID-19 is stronger than influenza A (H1N1) pdm09. The spread of COVID-19 in China has been controlled owe to the strict “lockdown” strategy.

Key words:

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图 1 2009年H1N1流感大流行的R₀相关文献筛选流程图

Figure 1. Flow chart of influenza A (H1N1) pdm09 R₀ related literature screening

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图 2 2009年H1N1流感大流行相关文献的R₀分布箱式图

Figure 2. Distribution of R₀ of influenza A (H1N1) pdm09 in literatures

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图 3 COVID-19的R₀相关文献筛选流程图

Figure 3. Flow chart of COVID-19 R₀ related literature screening

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图 4 COVID-19相关文献的R₀分布箱式图

Figure 4. Distribution of R₀ of COVID-19 in literatures

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表 1 2009年部分国家H1N1流感大流行的R₀中位数

Table 1. Medians of R₀ of influenza A (H1N1) pdm09 in some countries

影响因素	分层水平	国家	R₀中位数（IQR）	文献数目（篇）	文献^a	分层结果	H值	P值
国家经济发展水平	高收入国家	美国	2.042 （1.553～3.178）	6	［37,45,48,50,51-52］	1.350 （1.295～1.803）		0.229
		加拿大	1.710 （1.325～1.895）	5	［20,31-32,34,44］
		英国	1.420	1	［22］		2.945
		日本	1.385	2	［16,33］
		挪威	1.350	1	［4］
		新西兰	1.340	1	［35］
		意大利	1.280	1	［13］
		西班牙	1.235	2	［27,40］
		澳大利亚	1.242	2	［5,35］
	中高收入国家	泰国	3.580	3	［14,24,30］	1.545 （1.378～2.559）
		伊朗	2.018	2	［18,36］
		墨西哥	1.580 （1.420～1.690）	5	［6,11,15,21,46］
		阿根廷	1.545	2	［25,35］
		智利	1.313	2	［12,35］
		南非	1.370	1	［35］
		巴西	1.355	1	［35］
	中低收入国家	印度	2.035	2	［17,39］	1.527 （1.440～1.820）
		中国	1.529 （1.350～1.820）	15	［7,8,9,23,26, 28-29,38,41-43,47, 49,53-54］
		玻利维亚	1.440	1	［35］
		摩洛哥	1.440	1	［2］
人口密度	人口密集区	日本，泰国，意大利，印度，英国，中国	/	24	［7-9,13-14,16-17,22-24,26,28-30,33,38-39,41-43,47,49,53-54］	1.527 （1.368～1.897）	3.554	0.169
	人口中等区	巴西，美国，摩洛哥，墨西哥，南非，西班牙，伊朗	/	17	［2,6,11,15,18,21,27,35-37,40,45-46,48,50-52］	1.535 （1.374～2.193）
	人口稀少区	阿根廷，澳大利亚，玻利维亚，加拿大，挪威，新西兰，智利	/	10	［4-5,12,20,25,31-32,34-35,44］	1.350 （1.270～1.550）
注：参考文献［1］和［10］中的病例为来自墨西哥的输入型病例，未说明所在国家；参考文献［3］（欧洲国家）和［19］（全球）未纳入分析；/. 单个国家的R₀数据已在表1的国家经济发展水平中列出，因此在人口密度中不再重复描述

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表 2 COVID-19相关文献的R₀的中位数和变异程度（协变量）

Table 2. Median and variation (covariates) of R₀ of COVID-19 in literatures

影响因素	分层水平	国家	文献数目（篇）	文献^a	R₀中位数（IQR）	H值	P值
国家经济发展水平	高收入国家	韩国，西班牙，阿根廷，阿联酋，爱尔兰，奥地利，澳大利亚，巴拿马，比利时，波兰，丹麦，德国，法国，芬兰，荷兰，加拿大，捷克，卡塔尔，意大利，美国，挪威，葡萄牙，日本，瑞典，瑞士，沙特阿拉伯，希腊，新加坡，以色列，英国，智利	38	［3,6,12-13,15-17,19-20,24-26,28-32,34,36,39,41-42,46, 52,54-55,62-64,69,72-74,76,82,91,94-95］	2.595（2.343～3.578）	1.225	0.542
	中高收入国家	阿尔巴尼亚，阿尔及利亚，巴西，白俄罗斯，多米尼加，俄罗斯联邦，厄瓜多尔，哥伦比亚，罗马尼亚，马来西亚，秘鲁，墨西哥，南非，塞尔维亚，斯里兰卡，土耳其，伊朗，中国	73	［3-5,7-11,14,18,20-24,26-27,33,37-38,42-45,47-54,56-57,59-60,65-67,70-71,75-85,87-89,91-93,96-110］	2.985（2.385～3.580）
	中低收入国家	埃及，巴基斯坦，菲律宾，孟加拉国，突尼斯，乌克兰，印度，印度尼西亚	5	［2,35,42,52,58］	2.690（2.320～3.415）
人口密度	人口密集区	新加坡，孟加拉国，韩国，荷兰，印度，以色列，比利时，菲律宾，日本，斯里兰卡，巴基斯坦，英国，卡塔尔，德国，多米尼加，瑞士，意大利，中国，印度尼西亚，丹麦，捷克，阿联酋，波兰，法国，葡萄牙，奥地利，土耳其，阿尔巴尼亚	91	［3,5-8,10-20,22-24,26-39,41-45,47,49,51-52,54-60,62-67,69,71-73,75-85,87-89,91-94,96-110］	2.800（2.290～3.490）	3.586	0.166
	人口中等区	埃及、马来西亚、西班牙、罗马尼亚、希腊、塞尔维亚、乌克兰、突尼斯、爱尔兰、厄瓜多尔、墨西哥、巴拿马、伊朗、南非、白俄罗斯、哥伦比亚、美国、智利、巴西、瑞典	16	［2-4,19,25,39,42,48,50,52-53,70,74,82,91,95］	2.860（2.415～3.633）
	人口稀少区	秘鲁、芬兰、阿尔及利亚、阿根廷、沙特阿拉伯、挪威、俄罗斯联邦、澳大利亚	7	［9,21,42,46,52,77,82］	3.200（2.540～4.060）
预印本	/	/	61	［1-2,4,6,8,10,12,14,18-19,21-23,25-26,34-35,37,39,41-42,44-46,48,50,52-53,55,62-64,76,79-81,83-85,90-92,94-95］	2.860（2.353～3.472）	−0.164^b	0.870
非预印本	/	/	49	［3,5,7，9,11,13,15-17,20,24, 27-28,33,36,38,40,43,47,49,51, 54,56,61,65,75,77-78,82,86-89, 93,96,97-110］	2.910（2.150～4.061）
注：b. Z统计量；/. 预印本和非预印本不涉及分层水平和国家

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表 3 中国实施严格交通管制前后的COVID-19的R₀分析

Table 3. R₀ of COVID-19 before and after lockdown of Wuhan in China

时间	文献	地点	R₀	中位数（IQR）
实施严格交通管制前				3.430 （2.500～4.710）
	［71］	中国内地	6.470
	［72］	中国内地	3.800
	［80］	中国内地	3.600
	［6］	中国湖北省	5.945
	［33］	中国内地	4.380
	［55］	中国湖北省武汉市	3.110
	［56］	中国内地	2.220
	［81］	中国内地	5.500
	［43］	中国湖北省武汉市	2.550
	［63］	中国	4.710
	［34］	中国	2.200
	［9］	中国湖北省武汉市	3.580
	［76］	中国湖北省武汉市	3.380
	［8］	中国湖北省武汉市	3.240
	［105］	中国湖北省武汉市	5.750
	［18］	中国湖北省武汉市	3.430
	［93］	中国大陆	2.420
	［96］	中国湖北省武汉市	2.500
	［45］	中国	2.430
实施严格交通管制后				2.500 （1.673～3.030）
	［33］	中国内地	3.410
	［67］	中国北京市	3.110
	［67］	中国上海市	2.780
	［67］	中国广东省广州市	2.020
	［67］	中国广东省深圳市	1.750
	［101］	中国湖北省	2.950
	［97］	中国粤西地区	1.595
	［105］	中国湖北省武汉市	2.500
	［74］	中国湖北省武汉市	1.440
注：R₀. 基本传染数

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表 4 2009年H1N1流感大流行与COVID-19的R₀比较结果

Table 4. R₀ comparison of influenza A（H1N1）pdm09 and COVID-19

地区	2009年H1N1流感大流行		COVID-19
地区	R₀中位数	四分位数范围（IQR）	R₀中位数	四分位数范围（IQR）	Z值	P值
全球	1.508	1.336～1.836	2.860	2.350～3.560	−8.437	<0.001
中国	1.529	1.350 ~ 1.820	2.930	2.215 ~ 3.453	−4.158	<0.001
注：R₀. 基本传染数

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表 5 2009年H1N1流感大流行与COVID-19的R₀的Meta分析结果

Table 5. Meta-analysis on R₀ of influenza A（H1N1）pdm09 and COVID-19

传染病	地区	文献数目（篇）	R₀数据个数	R₀	95%CI	Q值	P值	I²（%）
2009 H1N1流感大流行	全球	20	26	1.599	1.480～1.719	11 256.636	<0.001	99.78
COVID-19	全球	45	66	3.260	3.022～3.498	30 4811.735	<0.001	99.98
	国外	24	44	3.406	3.122～3.690	22 2197.800	<0.001	99.98
	中国	22	22	2.908	2.601～3.216	7 228.587	<0.001	99.71
	中国除湖北省外　其他省市	6	6	1.036	0.313～1.759	4.242	0.5151	0.00
	中国湖北省武汉市	6	6	2.209	0.492～3.926	0.672	0.9845	0.00
	预印本文献	28	36	3.251	2.853～3.650	18 778.573	<0.001	99.81
	非预印本文献	17	30	3.335	2.949～3.720	115 873.353	<0.001	99.97
注：R₀. 基本传染数

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1.
沈阳化工大学材料科学与工程学院沈阳 110142

基于系统综述的新型冠状病毒肺炎与2009年H1N1流感大流行基本传染数研究

通信作者: 舒跃龙, shuylong@mail.sysu.edu.cn

English

Study of R0 of COVID-19 and pandemic influenza A (H1N1) 2009 based on systematic review

Corresponding author: Yuelong Shu, shuylong@mail.sysu.edu.cn

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通信作者: 陈斌, bchen63@163.com

Study of R₀ of COVID-19 and pandemic influenza A (H1N1) 2009 based on systematic review