Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China.
Department of Respiratory and Critical Care Medicine, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China.
Chin Med J (Engl). 2020 May 5;133(9):1025-1031. doi: 10.1097/CM9.0000000000000744.
The 2019 novel coronavirus (2019-nCoV) causing an outbreak of pneumonia in Wuhan, Hubei province of China was isolated in January 2020. This study aims to investigate its epidemiologic history, and analyze the clinical characteristics, treatment regimens, and prognosis of patients infected with 2019-nCoV during this outbreak.
Clinical data from 137 2019-nCoV-infected patients admitted to the respiratory departments of nine tertiary hospitals in Hubei province from December 30, 2019 to January 24, 2020 were retrospectively collected, including general status, clinical manifestations, laboratory test results, imaging characteristics, and treatment regimens.
None of the 137 patients (61 males, 76 females, aged 20-83 years, median age 57 years) had a definite history of exposure to Huanan Seafood Wholesale Market. Major initial symptoms included fever (112/137, 81.8%), coughing (66/137, 48.2%), and muscle pain or fatigue (44/137, 32.1%), with other, less typical initial symptoms observed at low frequency, including heart palpitations, diarrhea, and headache. Nearly 80% of the patients had normal or decreased white blood cell counts, and 72.3% (99/137) had lymphocytopenia. Lung involvement was present in all cases, with most chest computed tomography scans showing lesions in multiple lung lobes, some of which were dense; ground-glass opacity co-existed with consolidation shadows or cord-like shadows. Given the lack of effective drugs, treatment focused on symptomatic and respiratory support. Immunoglobulin G was delivered to some critically ill patients according to their conditions. Systemic corticosteroid treatment did not show significant benefits. Notably, early respiratory support facilitated disease recovery and improved prognosis. The risk of death was primarily associated with age, underlying chronic diseases, and median interval from the appearance of initial symptoms to dyspnea.
The majority of patients with 2019-nCoV pneumonia present with fever as the first symptom, and most of them still showed typical manifestations of viral pneumonia on chest imaging. Middle-aged and elderly patients with underlying comorbidities are susceptible to respiratory failure and may have a poorer prognosis.
2019 年新型冠状病毒（2019-nCoV）引发的肺炎疫情于 2020 年 1 月在湖北省武汉市爆发。本研究旨在调查其流行病学史，并分析此次疫情期间感染 2019-nCoV 的患者的临床特征、治疗方案和预后。
回顾性收集 2019 年 12 月 30 日至 2020 年 1 月 24 日湖北省 9 家三级医院呼吸科收治的 137 例 2019-nCoV 感染患者的临床资料，包括一般情况、临床表现、实验室检查结果、影像学特征和治疗方案。
137 例患者（男 61 例，女 76 例，年龄 20-83 岁，中位年龄 57 岁）均无明确的华南海鲜市场暴露史。主要首发症状包括发热（112/137，81.8%）、咳嗽（66/137，48.2%）和肌肉疼痛或乏力（44/137，32.1%），其他不典型首发症状少见，频率较低，包括心悸、腹泻和头痛。近 80%的患者白细胞计数正常或降低，72.3%（99/137）患者淋巴细胞减少。所有患者均有肺部受累，胸部计算机断层扫描（CT）显示多数为多肺叶病变，部分呈致密影；磨玻璃影与实变影或条索影共存。由于缺乏有效的药物，治疗主要集中在对症和呼吸支持上。根据病情，一些危重症患者给予免疫球蛋白 G。全身皮质类固醇治疗并未显示出显著益处。值得注意的是，早期呼吸支持有利于疾病康复和改善预后。死亡风险主要与年龄、基础慢性疾病和从首发症状到呼吸困难的中位间隔时间相关。
2019-nCoV 肺炎患者多数以发热为首发症状，胸部影像学仍表现为典型病毒性肺炎表现。中老年人合并基础疾病者易发生呼吸衰竭，预后可能较差。
