[1]赵琴,雷旭,刘龙,等.湖北省十堰市新型冠状病毒肺炎49例临床分析[J].第三军医大学学报,2020,42(09):867-871.
 ZHAO Qin,LEI Xu,LIU Long,et al.Clinical analysis of 49 cases of coronavirus disease 2019 in Shiyan, Hubei Province[J].J Third Mil Med Univ,2020,42(09):867-871.
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湖北省十堰市新型冠状病毒肺炎49例临床分析(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
42卷
期数:
2020年第09期
页码:
867-871
栏目:
特别报道
出版日期:
2020-05-15

文章信息/Info

Title:
Clinical analysis of 49 cases of coronavirus disease 2019 in Shiyan, Hubei Province
作者:
赵琴 雷旭 刘龙 占国清 李儒贵 李金科 李芳 杜卫星 李健 杨靖 谭华炳
十堰市人民医院(湖北医药学院附属人民医院)感染性疾病科,湖北医药学院肝病研究所;房县人民医院检验科
Author(s):
ZHAO Qin LEI Xu LIU Long ZHAN Guoqing LI Rugui LI Jinke LI Fang DU Weixing LI Jian YANG Jing TAN Huabing

Department of Infectious Disease, Institute of Liver Disease, People’s Hospital of Shiyan City, Hubei University of Medicine, Shiyan, Hubei Province, 442000; 2Department of Clinical Laboratory, People’s Hospital of Fangxian County, Fangxian, Hubei Province, 442100, China

关键词:
新型冠状病毒肺炎临床症状核酸检测螺旋CT
Keywords:
coronavirus disease 2019 clinical symptoms nucleic acid test multi-slice CT
分类号:
R181.32; R373.1; R563.19
文献标志码:
A
摘要:

目的分析湖北省十堰市新型冠状病毒肺炎(coronavirus disease 2019, COVID-19)临床特点,并与近期收治流行性感冒(12例合并肺炎)患者进行比较。方法 收集十堰市人民医院(湖北医药学院附属人民医院)2020年1月23日至2月9日确诊的49例COVID-19患者(COVID-19组),分析其临床表现、流行病学史、实验室检查、螺旋CT(MSCT)检查结果,并与2019年12月1日至2020年1月31日治疗的31例流行性感冒(12例合并肺炎)组(流感组)进行比较和分析。结果(1)发热和体温变化:COVID-19组以发热为主诉占87.76%,低于流感组(96.77%,P<0.05);COVID-19组以低热(22例)、中度发热(21例)为主,与流感组以中度发热(12例)、高热(18例)为主不同(P<0.05)。(2)咳嗽、咳痰:COVID-19组咳嗽、咳痰发生率为65.31%,低于流感组(93.55%,P<0.01)。(3)喷嚏、流涕:COVID-19组喷嚏、流涕发生率为2.04%,低于流感组(96.77%,P<0.001)。(4)气促、胸闷:COVID-19组发生率为12.24%,低于流感组(29.03%,P<0.05)。(5)乏力、纳差:COVID-19组发生率为34.69%,高于流感组(6.45%,P<0.01)。(6)腹泻:COVID-19组发生率为6.12%,流行性感冒(12例合并肺炎)组无腹泻病例。(7)白细胞计数(WBC):COVID-19组WBC低于正常发生率为77.55%,高于流感组(16.13%,P<0.01)。(8)淋巴细胞计数:COVID-19组淋巴细胞计数低于正常发生率为38.78%,高于流感组(6.45%,P<0.01)。(9)COVID-19组MSCT表现:1~3次MSCT检查,病灶位于双侧占91.84%,具有典型影像学表现。(10)新型冠状病毒核酸检测:第1次阳性率为77.55%,第2次总阳性率为89.80%,第3次总阳性率为97.96%,第4次阳性率为100%。结论与流行性感冒相比,十堰地区COVID-19发热以低至中度为主,畏寒少见;干咳,咳痰少见;喷嚏、流涕极少见;WBC下降、淋巴细胞下降发生率不高;诊断需结合临床、流行病学、核酸检查和MSCT表现。

Abstract:

ObjectiveTo analyze the clinical characteristics of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Shiyan, Hubei Province, and to compare the features with those of the recent treatment of influenza. MethodsForty-nine diagnosed COVID-19 patients admitted to the People’s Hospital of Shiyan City from January 23 to February 9, 2020 were recruited in this study. Their clinical manifestations, epidemiological history, results of laboratory tests, and images of multi-slice CT (MSCT) examination were collected and analyzed, and the results were compared with the features of 31 cases of influenza virus infection (12 cases, accompanying pneumonia) during the same period. Results① Fever and body temperature: Fever was the main complaint of the COVID-19 patients (87.76%), and the rate was significant lower than the influenza group (96.77%, P<0.05). The COVID-19 group had low fever (22 cases) and moderate fever (21 cases) which were mainly different from those with moderate fever (12 cases) and high fever (18 cases) in the influenza group (P<0.05). ② Cough and sputum: The incidence of cough and sputum was 65.31% in the COVID-19 group, which was significantly lower than that of the influenza group (93.55%, P<0.01). ③ Sneezing and rhinorrhea: The incidence in the COVID-19 group was 2.04%, obviously lower than that of the influenza group (96.77%, P<0.001). ④ Shortness of breath and chest tightness: The incidence was 12.24% in the COVID-19 group, and 29.03% in the influenza group (P<0.05). ⑤ Fatigue and anorexia: The incidence rate was 34.69% in COVID-19 group, significantly higher than that of the influenza group (6.45%, P<0.01). ⑥ Diarrhea: The incidence rate was 6.12% in the COVID-19 group, and no case was seen in the influenza group. ⑦ WBC count: The COVID-19 patients having a lower WBC count accounted for 77.55%, which was lower than the health control but higher than that of the influenza group (16.13%, P<0.01). ⑧ Lymphocyte count: 38.78% COVID-19 patients had a lower lymphocyte ratio, but only 6.45% in the influenza group (P<0.01). ⑨ Multi-slice CT (MSCT): All COVID-19 patients underwent 1 to 3 times of MSCT examination, and typical imaging features (bilateral lesions) were found in 91.84% patients. ⑩ Nucleic acid test: 77.55% patients were positive in the first time, 89.80% was in the second, 97.96% in the third, and 100% in the fourth. ConclusionCompared with influenza, COVID-19 are characterized by mainly low to moderate fever, rare chills, dry cough and sputum, very rear sneezing and runny nose, decreased WBC count, and not higher incidence of lymphocyte decline. The diagnosis needs based on the combination of clinical manifestation, epidemiological data, nucleic acid test and MSCT findings.

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更新日期/Last Update: 2020-05-06