Tuberculosis and Respiratory Department, Wuhan Jinyintan Hospital, Wuhan, China.
Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China; Institute of Respiratory Diseases, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Lancet. 2020 Feb 15;395(10223):507-513. doi: 10.1016/S0140-6736(20)30211-7. Epub 2020 Jan 30.
BACKGROUND: In December, 2019, a pneumonia associated with the 2019 novel coronavirus (2019-nCoV) emerged in Wuhan, China. We aimed to further clarify the epidemiological and clinical characteristics of 2019-nCoV pneumonia. METHODS: In this retrospective, single-centre study, we included all confirmed cases of 2019-nCoV in Wuhan Jinyintan Hospital from Jan 1 to Jan 20, 2020. Cases were confirmed by real-time RT-PCR and were analysed for epidemiological, demographic, clinical, and radiological features and laboratory data. Outcomes were followed up until Jan 25, 2020. FINDINGS: Of the 99 patients with 2019-nCoV pneumonia, 49 (49%) had a history of exposure to the Huanan seafood market. The average age of the patients was 55·5 years (SD 13·1), including 67 men and 32 women. 2019-nCoV was detected in all patients by real-time RT-PCR. 50 (51%) patients had chronic diseases. Patients had clinical manifestations of fever (82 [83%] patients), cough (81 [82%] patients), shortness of breath (31 [31%] patients), muscle ache (11 [11%] patients), confusion (nine [9%] patients), headache (eight [8%] patients), sore throat (five [5%] patients), rhinorrhoea (four [4%] patients), chest pain (two [2%] patients), diarrhoea (two [2%] patients), and nausea and vomiting (one [1%] patient). According to imaging examination, 74 (75%) patients showed bilateral pneumonia, 14 (14%) patients showed multiple mottling and ground-glass opacity, and one (1%) patient had pneumothorax. 17 (17%) patients developed acute respiratory distress syndrome and, among them, 11 (11%) patients worsened in a short period of time and died of multiple organ failure. INTERPRETATION: The 2019-nCoV infection was of clustering onset, is more likely to affect older males with comorbidities, and can result in severe and even fatal respiratory diseases such as acute respiratory distress syndrome. In general, characteristics of patients who died were in line with the MuLBSTA score, an early warning model for predicting mortality in viral pneumonia. Further investigation is needed to explore the applicability of the MuLBSTA score in predicting the risk of mortality in 2019-nCoV infection. FUNDING: National Key R&D Program of China.
背景：2019 年 12 月，在中国武汉出现了一种与 2019 年新型冠状病毒（2019-nCoV）相关的肺炎。我们旨在进一步阐明 2019-nCoV 肺炎的流行病学和临床特征。
方法：在这项回顾性、单中心研究中，我们纳入了 2020 年 1 月 1 日至 1 月 20 日期间武汉金银潭医院所有确诊的 2019-nCoV 病例。病例通过实时 RT-PCR 确诊，并对其流行病学、人口统计学、临床和影像学特征以及实验室数据进行分析。研究结果随访至 2020 年 1 月 25 日。
结果：在 99 例 2019-nCoV 肺炎患者中，49 例（49%）有华南海鲜市场暴露史。患者平均年龄为 55.5 岁（标准差 13.1），包括 67 名男性和 32 名女性。实时 RT-PCR 检测到所有患者均感染了 2019-nCoV。50 例（51%）患者患有慢性病。患者临床表现为发热（82[83%]例）、咳嗽（81[82%]例）、呼吸急促（31[31%]例）、肌肉疼痛（11[11%]例）、意识混乱（9[9%]例）、头痛（8[8%]例）、咽痛（5[5%]例）、流涕（4[4%]例）、胸痛（2[2%]例）、腹泻（2[2%]例）和恶心呕吐（1[1%]例）。根据影像学检查，74 例（75%）患者表现为双侧肺炎，14 例（14%）患者表现为多发性斑片状和磨玻璃影，1 例（1%）患者发生气胸。17 例（17%）患者发生急性呼吸窘迫综合征，其中 11 例（11%）患者在短时间内病情恶化并死于多器官功能衰竭。
结论：2019-nCoV 感染呈聚集性发病，更易影响有合并症的老年男性，并可导致严重甚至致命的呼吸道疾病，如急性呼吸窘迫综合征。一般来说，死亡患者的特征与 MuLBSTA 评分相符，该评分是一种预测病毒性肺炎死亡率的早期预警模型。需要进一步研究来探讨 MuLBSTA 评分在预测 2019-nCoV 感染死亡风险中的适用性。
资金：国家重点研发计划。
Zhonghua Jie He He Hu Xi Za Zhi. 2021-4-12
Eur J Nucl Med Mol Imaging. 2020-2-28
World J Gastroenterol. 2025-8-21
Front Microbiol. 2019-12-3
Viruses. 2019-1-14
Nat Rev Microbiol. 2019-3
Respirology. 2017-10-20
Zotero 插件