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[北京某发热门诊2019新型冠状病毒肺炎早期临床特征]

[Clinical features of 2019 novel coronavirus pneumonia in the early stage from a fever clinic in Beijing].

作者信息

Zhang M Q, Wang X H, Chen Y L, Zhao K L, Cai Y Q, An C L, Lin M G, Mu X D

机构信息

Department of Respiratory Medicine, Peking University First Hospital, Beijing 100034, China.

Department of kidney surgery, Peking University First Hospital, Beijing 100034, China.

出版信息

Zhonghua Jie He He Hu Xi Za Zhi. 2020 Mar 12;43(3):215-218. doi: 10.3760/cma.j.issn.1001-0939.2020.03.015.

Abstract

To summarize and analyze the clinical and imaging characteristics of patients with 2019 novel coronavirus pneumonia in the early stage in Beijing. A retrospective analysis of clinical and imaging data of 9 patients with 2019 novel coronavirus infection diagnosed in one fever clinicic in Beijing from January 18, 2020 to February 3, 2020. 5 male and 4 female was included in those 9 patients, whose median age was 36 years, and the age range from 15 to 49 years. 8 of these patients had no underlying disease and one suffered from diabetes. 7 patients had a history of travel to Wuhan City or Hubei Province, and one patient was a medical staff. Two family clustered was found. The incubation period was 1 to 6 days. The clinical manifestations were fever in 8 cases (8/9) , dry cough in 5 cases (5/9) , pharyngalgia in 4 cases (4/9) , fatigue in 4 cases (4/9) , body soreness in 4 cases (4/9) , and blocked or watery nose in 1 case (1/9) . Six patients (6/9) had abnormal cell peripheral blood, of which 3 (3/9) had an increased monocyte count, 2 (2/9) had a reduced lymphocyte, and 1 (1/9) had an increased leukocyte count, while the 3 patients had normal cell blood routines. The median of CRP was 16.3 mg/L, including 5 patients with slightly elevated (5/9) , 4 patients with normal values (4/9) . the results of procalcitonin test were negative in5 patients. Three patients were examined by chest X-ray examination, one of which was normal, one case showed infiltrates of right upper lung, and another showed in right lower lung. All patients underwent chest HRCT. And 7 cases (7/9) showed multiple ground glass exudation, including 5 cases (5/7) involved bilateral lungs, 2 cases (2/7) involved unilateral lung, 3 cases (3/7) with patchy consolidation, and 2 cases (2/9) showed no abnormality. The patents with 2019 novel coronavirus pneumonia in this study generally have an epidemiological history. The clinical manifestations are fever and cough. Peripheral white blood cell counts were most normal And PCT were all negative. Chest HRCT manifested as multiple ground-glass opacities with partly consolidation. Some patients had normal chest radiographs but HRCT showed pneumonia. Some patients had no pneumonia on chest HRCT.

摘要

总结分析北京地区2019新型冠状病毒肺炎患者早期的临床及影像特征。回顾性分析2020年1月18日至2月3日在北京某发热门诊确诊的9例2019新型冠状病毒感染患者的临床及影像资料。9例患者中男性5例,女性4例,年龄中位数为36岁,年龄范围为15至49岁。其中8例患者无基础疾病,1例患有糖尿病。7例患者有武汉市或湖北省旅行史,1例患者为医务人员。发现2起家庭聚集性发病。潜伏期为1至6天。临床表现为发热8例(8/9)、干咳5例(5/9)、咽痛4例(4/9)、乏力4例(4/9)、全身酸痛4例(4/9)、鼻塞或流涕1例(1/9)。6例患者(6/9)外周血细胞异常,其中3例(3/9)单核细胞计数升高,2例(2/9)淋巴细胞减少,1例(1/9)白细胞计数升高,另3例患者血常规正常。CRP中位数为16.3mg/L,其中5例轻度升高(5/9),4例正常(4/9)。降钙素原检测结果5例为阴性。3例患者行胸部X线检查,其中1例正常,1例右上肺有渗出,另1例右下肺有渗出。所有患者均行胸部HRCT检查。7例(7/9)表现为多发磨玻璃样渗出,其中5例(5/7)累及双侧肺,2例(2/7)累及单侧肺,3例(3/7)有片状实变,2例(2/9)无异常。本研究中2019新型冠状病毒肺炎患者一般有流行病学史。临床表现为发热、咳嗽。外周血白细胞计数大多正常,PCT均为阴性。胸部HRCT表现为多发磨玻璃影伴部分实变。部分患者胸部X线正常但HRCT显示肺炎。部分患者胸部HRCT未见肺炎。

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