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中国武汉 140 名 SARS-CoV-2 感染患者的临床特征。

Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China.

机构信息

Department of Allergology, Zhongnan Hospital of Wuhan University, Wuhan, China.

Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China.

出版信息

Allergy. 2020 Jul;75(7):1730-1741. doi: 10.1111/all.14238. Epub 2020 Feb 27.

Abstract

BACKGROUND

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been widely spread. We aim to investigate the clinical characteristic and allergy status of patients infected with SARS-CoV-2.

METHODS

Electronic medical records including demographics, clinical manifestation, comorbidities, laboratory data, and radiological materials of 140 hospitalized COVID-19 patients, with confirmed result of SARS-CoV-2 viral infection, were extracted and analyzed.

RESULTS

An approximately 1:1 ratio of male (50.7%) and female COVID-19 patients was found, with an overall median age of 57.0 years. All patients were community-acquired cases. Fever (91.7%), cough (75.0%), fatigue (75.0%), and gastrointestinal symptoms (39.6%) were the most common clinical manifestations, whereas hypertension (30.0%) and diabetes mellitus (12.1%) were the most common comorbidities. Drug hypersensitivity (11.4%) and urticaria (1.4%) were self-reported by several patients. Asthma or other allergic diseases were not reported by any of the patients. Chronic obstructive pulmonary disease (COPD, 1.4%) patients and current smokers (1.4%) were rare. Bilateral ground-glass or patchy opacity (89.6%) was the most common sign of radiological finding. Lymphopenia (75.4%) and eosinopenia (52.9%) were observed in most patients. Blood eosinophil counts correlate positively with lymphocyte counts in severe (r = .486, P < .001) and nonsevere (r = .469, P < .001) patients after hospital admission. Significantly higher levels of D-dimer, C-reactive protein, and procalcitonin were associated with severe patients compared to nonsevere patients (all P < .001).

CONCLUSION

Detailed clinical investigation of 140 hospitalized COVID-19 cases suggests eosinopenia together with lymphopenia may be a potential indicator for diagnosis. Allergic diseases, asthma, and COPD are not risk factors for SARS-CoV-2 infection. Older age, high number of comorbidities, and more prominent laboratory abnormalities were associated with severe patients.

摘要

背景

由严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)感染引起的 2019 年冠状病毒病(COVID-19)已广泛传播。我们旨在研究感染 SARS-CoV-2 的患者的临床特征和过敏状况。

方法

提取并分析了 140 例经 SARS-CoV-2 病毒感染确诊的住院 COVID-19 患者的电子病历,包括人口统计学、临床表现、合并症、实验室数据和影像学资料。

结果

发现 COVID-19 患者中男女比例约为 1:1,总体中位年龄为 57.0 岁。所有患者均为社区获得性病例。发热(91.7%)、咳嗽(75.0%)、乏力(75.0%)和胃肠道症状(39.6%)是最常见的临床表现,而高血压(30.0%)和糖尿病(12.1%)是最常见的合并症。数名患者自述有药物过敏(11.4%)和荨麻疹(1.4%)。但无任何患者报告哮喘或其他过敏疾病。慢性阻塞性肺疾病(COPD,1.4%)患者和当前吸烟者(1.4%)很少见。双侧磨玻璃影或斑片状影(89.6%)是最常见的影像学表现。大多数患者均存在淋巴细胞减少(75.4%)和嗜酸性粒细胞减少(52.9%)。入院后严重(r =.486,P <.001)和非严重(r =.469,P <.001)患者的血嗜酸性粒细胞计数与淋巴细胞计数呈正相关。与非重症患者相比,重症患者的 D-二聚体、C 反应蛋白和降钙素原水平显著更高(均 P <.001)。

结论

对 140 例住院 COVID-19 病例的详细临床调查表明,嗜酸性粒细胞减少伴淋巴细胞减少可能是诊断的潜在指标。过敏疾病、哮喘和 COPD 不是 SARS-CoV-2 感染的危险因素。年龄较大、合并症较多和更明显的实验室异常与重症患者相关。

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