Li Y Y, Wang W N, Lei Y, Zhang B, Yang J, Hu J W, Ren Y L, Lu Q F
Department of Respiratory Medicine, Wuhan Forth Hospital, Puai Hospital Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Department of Medical Affaires, Liyuan Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2020 May 12;43(5):427-430. doi: 10.3760/cma.j.cn112147-20200214-00095.
To raise awareness about 2019 novel coronavirus pneumonia (NCP) and reduce missed diagnosis rate and misdiagnosis rate by comparing the clinical characteristics between RNA positive and negative patients clinically diagnosed with NCP. From January 2020 to February 2020, 54 patients who were newly diagnosed with NCP in Wuhan Fourth Hospital were included in this study. RT-PCR method was used to measure the level of 2019-nCov RNA in pharyngeal swab samples of these patients. The patients were divided into RNA positive and negative group, and the differences of clinical, laboratory, and radiological characteristics were compared. There were 31 RNA of 2019-nCov positive cases, and 23 negative cases. Common clinical symptoms of two groups were fever (80.64% vs. 86.96%) , chills (61.29% vs. 52.17%) , cough (80.64% vs. 95.65%) , fatigue (61.30% vs. 56.52%) , chest distress (77.42% vs.73.91%) . Some other symptoms were headache, myalgia, dyspnea, diarrhea, nausea and vomiting. The laboratory and radiological characteristics of two groups mainly were lymphopenia, increased erythrocyte sedimentation rate, increased C-reactive protein, increased lactate dehydrogenase, decreased oxygenation index, normal white blood cell count and bilateral chest CT involvement. There was no statistically significant difference in other clinical characteristics except for dyspnea between two groups. RNA positive and negative NCP patients shared similar clinical symptoms, while RNA positive NCP patients tended to have dyspnea. Therefore, we should improve the understanding of NCP to prevent missed diagnosis and misdiagnosis; In addition, more rapid and accurate NCP diagnostic approaches should be further developed.
通过比较临床诊断为新型冠状病毒肺炎（NCP）的RNA阳性和阴性患者的临床特征，提高对2019新型冠状病毒肺炎的认识，降低漏诊率和误诊率。2020年1月至2020年2月，纳入武汉市第四医院新诊断为NCP的54例患者。采用RT-PCR法检测这些患者咽拭子样本中2019-nCov RNA水平。将患者分为RNA阳性组和阴性组，比较临床、实验室及影像学特征的差异。2019-nCov RNA阳性病例31例，阴性病例23例。两组常见临床症状为发热（80.64%对86.96%）、寒战（61.29%对52.17%）、咳嗽（80.64%对95.65%）、乏力（61.30%对56.52%）、胸闷（77.42%对73.91%）。其他症状有头痛、肌痛、呼吸困难、腹泻、恶心和呕吐。两组实验室及影像学特征主要为淋巴细胞减少、红细胞沉降率升高、C反应蛋白升高、乳酸脱氢酶升高、氧合指数降低、白细胞计数正常及双侧胸部CT受累。除呼吸困难外，两组其他临床特征差异无统计学意义。RNA阳性和阴性的NCP患者临床症状相似，但RNA阳性的NCP患者更易出现呼吸困难。因此，应提高对NCP的认识以防止漏诊和误诊；此外，应进一步开发更快速准确的NCP诊断方法。
