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中国湖北省外两家急诊科的 2019 年疑似冠状病毒病的初始临床特征。

Initial clinical features of suspected coronavirus disease 2019 in two emergency departments outside of Hubei, China.

机构信息

Department of Emergency, The First Affiliated Hospital of University of Science and Technology of China, Hefei, China.

Department of Emergency, Affiliated Anhui Provincial Hospital of Anhui Medical University, Hefei, China.

出版信息

J Med Virol. 2020 Sep;92(9):1525-1532. doi: 10.1002/jmv.25763. Epub 2020 Mar 24.

Abstract

With an increasing number of Coronavirus Disease 2019 (COVID-19) cases outside of Hubei, emergency departments (EDs) and fever clinics are facing challenges posed by the large number of admissions of patients suspected to have COVID-19. Therefore, it is of crucial importance to study the initial clinical features of patients, to better differentiate between infected and uninfected patients outside Hubei. A total of 116 patients suspected of having COVID-19 who presented to two emergency departments in Anhui for the first time between 24 January 2020 and 20 February 2020 were enrolled in the study. The initial clinical data of these patients, such as epidemiological features, symptoms, laboratory results, and chest computed tomography (CT) findings were collected using a standard case report form on admission. Thirty-two patients were diagnosed with COVID-19; the remaining 84 patients were referred to as negative cases. The median age of the diagnosed patients was 46 years, but only 35 years for negative cases. History of exposure to Wuhan or COVID-19 patients in the previous 2 weeks was observed in 63% of the diagnosed and 44% of negative cases. Median time from illness onset to ED admission was 5 days for all patients, diagnosed patients, and negative cases, respectively. Fever was observed in 27 (84%) and 57 (68%) diagnosed and negative cases, respectively. Nineteen (59%) diagnosed and 24 (29%) negative cases had lymphopenia on admission in ED. A chest CT scan on admission revealed the presence of pneumonia in the majority of the diagnosed patients (30 out of 32, 94%) and in 56 (67%) negative cases. Bilateral involvement and ground-glass opacity (GGO) were present in 91% and 47% of the diagnosed patients. Thirty-two patients were diagnosed with COVID-19; the remaining 84 patients were referred to as negative cases. The median age of the diagnosed patients was 46 years, but only 35 years for negative cases. History of exposure to Wuhan or COVID-19 patients in the previous 2 weeks was observed in 63% of the diagnosed and 44% of negative cases. Median time from illness onset to ED admission was 5 days for all patients, diagnosed patients, and negative cases, respectively. Fever was observed in 27 (84%) and 57 (68%) diagnosed and negative cases, respectively. Nineteen (59%) diagnosed and 24 (29%) negative cases had lymphopenia on admission in ED. A chest CT scan on admission revealed the presence of pneumonia in the majority of the diagnosed patients (30 out of 32, 94%) and in 56 (67%) negative cases. Bilateral involvement and GGO were present in 91% and 47% of the diagnosed patients.

摘要

随着湖北省以外的 2019 年冠状病毒病(COVID-19)病例数量不断增加,急诊科(ED)和发热门诊正面临着大量疑似 COVID-19 患者入院带来的挑战。因此,研究患者的初始临床特征对于区分湖北省内外的感染者和未感染者至关重要。本研究共纳入了 2020 年 1 月 24 日至 2 月 20 日期间首次到安徽两家急诊科就诊的 116 例疑似 COVID-19 患者。入院时使用标准病例报告表收集这些患者的初始临床数据,如流行病学特征、症状、实验室结果和胸部计算机断层扫描(CT)结果。32 例患者被诊断为 COVID-19;其余 84 例被归为阴性病例。确诊患者的中位年龄为 46 岁,而阴性病例仅为 35 岁。在确诊患者中,有 63%的患者和 44%的阴性病例在过去 2 周内有接触武汉或 COVID-19 患者的病史。所有患者、确诊患者和阴性病例从发病到急诊就诊的中位时间分别为 5 天。发热分别见于确诊患者和阴性患者中的 27 例(84%)和 57 例(68%)。入院时,19 例(59%)确诊患者和 24 例(29%)阴性患者出现淋巴细胞减少。入院时胸部 CT 扫描显示,大多数确诊患者(32 例中的 30 例,94%)和 56 例(67%)阴性患者存在肺炎。双侧受累和磨玻璃影(GGO)分别见于 91%和 47%的确诊患者。32 例患者被诊断为 COVID-19;其余 84 例被归为阴性病例。确诊患者的中位年龄为 46 岁,而阴性病例仅为 35 岁。在确诊患者中,有 63%的患者和 44%的阴性病例在过去 2 周内有接触武汉或 COVID-19 患者的病史。所有患者、确诊患者和阴性病例从发病到急诊就诊的中位时间分别为 5 天。发热分别见于确诊患者和阴性患者中的 27 例(84%)和 57 例(68%)。入院时,19 例(59%)确诊患者和 24 例(29%)阴性患者出现淋巴细胞减少。入院时胸部 CT 扫描显示,大多数确诊患者(32 例中的 30 例,94%)和 56 例(67%)阴性患者存在肺炎。双侧受累和磨玻璃影(GGO)分别见于 91%和 47%的确诊患者。

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