Department of Infection, Hull University Teaching Hospitals NHS Trust, Castle Hill Hospital, Hull, UK.
Influenza Other Respir Viruses. 2020 Jul;14(4):374-379. doi: 10.1111/irv.12739. Epub 2020 Apr 8.
Assessment of possible infection with SARS-CoV-2, the novel coronavirus responsible for COVID-19 illness, has been a major activity of infection services since the first reports of cases in December 2019.
We report a series of 68 patients assessed at a Regional Infection Unit in the UK.
Between 29 January 2020 and 24 February 2020, demographic, clinical, epidemiological and laboratory data were collected. We compared clinical features between patients not requiring admission for clinical reasons or antimicrobials with those assessed as needing either admission or antimicrobial treatment.
Patients assessed were aged from 0 to 76 years; 36/68 were female. Peaks of clinical assessments coincided with updates to the case definition for suspected COVID-19. Microbiological diagnoses included SARS-CoV-2, mycoplasma pneumonia, influenza A, non-SARS/MERS coronaviruses and rhinovirus/enterovirus. Nine of sixty-eight received antimicrobials, 15/68 were admitted, 5 due to inability to self-isolate. Patients requiring admission on clinical grounds or antimicrobials (14/68) were more likely to have fever or raised respiratory rate compared to those not requiring admission or antimicrobials.
The majority of patients had mild illness, which did not require clinical intervention. This finding supports a community testing approach, supported by clinicians able to review more unwell patients. Extensions of the epidemiological criteria for the case definition of suspected COVID-19 lead to increased screening intensity; strategies must be in place to accommodate this in time for forthcoming changes as the epidemic develops.
自 2019 年 12 月首次报告 COVID-19 病例以来,评估新型冠状病毒 SARS-CoV-2 可能感染情况一直是传染病服务的主要活动。
我们报告了英国一个地区传染病科评估的 68 例患者系列。
在 2020 年 1 月 29 日至 2 月 24 日期间,收集了人口统计学、临床、流行病学和实验室数据。我们比较了因临床或抗生素治疗原因无需住院的患者与需要住院或抗生素治疗的患者的临床特征。
评估的患者年龄从 0 岁到 76 岁不等;36/68 例为女性。临床评估高峰与 COVID-19 疑似病例定义的更新相吻合。微生物学诊断包括 SARS-CoV-2、肺炎支原体、甲型流感、非 SARS/MERS 冠状病毒和鼻病毒/肠道病毒。68 例中有 9 例接受了抗生素治疗,15 例住院,5 例因无法自我隔离。因临床或抗生素治疗需要住院的患者(14/68)与无需住院或抗生素治疗的患者相比,更有可能出现发热或呼吸频率升高。
大多数患者病情较轻,无需临床干预。这一发现支持社区检测方法,由能够审查更多病情较重患者的临床医生提供支持。疑似 COVID-19 病例定义的流行病学标准的扩展导致筛查强度增加;随着疫情的发展,必须及时制定策略来适应这一情况。