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成都 32 例危重症和 67 例非危重症 COVID-19 的流行病学特征和临床特征。

Epidemiological characteristics and clinical features of 32 critical and 67 noncritical cases of COVID-19 in Chengdu.

机构信息

Chengdu Public Health Clinical Medical Center & Public Health Clinical Center of Chengdu University of Traditional Chinese Medicine, Chengdu, China.

Chengdu Public Health Clinical Medical Center & Public Health Clinical Center of Chengdu University of Traditional Chinese Medicine, Chengdu, China.

出版信息

J Clin Virol. 2020 Jun;127:104366. doi: 10.1016/j.jcv.2020.104366. Epub 2020 Apr 10.

Abstract

BACKGROUND

In December 2019, Wuhan, China, experienced an outbreak of coronavirus (COVID-19). The number of cases has increased rapidly, but information on the clinical characteristics remains limited.

OBJECTIVES

This paper describes the epidemiological and clinical characteristics of COVID-19. Early detection and identification of critically ill patients is necessary to facilitate scientific classification and treatment.

STUDY DESIGN

This study included a retrospective, single-center case series of 99 consecutively hospitalized patients with confirmed COVID-19 at Chengdu Public Health Clinical Medical Center in Chengdu, China, from January 16 to February 20, 2020. The final date of follow-up was February 23, 2020. We collected and analyzed epidemiological, demographic, clinical, laboratory, radiological, and treatment data. We compared outcomes of critically ill patients and noncritically ill patients.

RESULTS

Of the 99 hospitalized patients with COVID-19, the median age was 49 years (minimum, 3 months; maximum, 87 years) and 51 (52 %) were men; 42 (42 %) had traveled to or lived in Wuhan and 48 (49 %) had come into close contact with patients with new coronavirus pneumonia; 41 (41 %) patients had underlying disease. Common symptoms included fever (85 [86 %]), dry cough (84 [85 %]), and fatigue (72 [73 %]). We analyzed the clinical characteristics of patients. We expressed the measurement data as mean ± standard deviation. We collected data for age (49.39 ± 18.45 years), number of hospital days (12.32 ± 6.70 days), and laboratory indicators. We compared critically ill and noncritically ill patients: p-values for age, C-reactive protein, high-sensitivity troponin T, prothrombin time, fibrin degradation products, D-Dimer, and CD4+ count were p < 0.001; and p-values for hospital days, white blood cell, neutrophil, lymphocyte, creatine kinase isoenzyme, myoglobin, N-terminal brain natriuretic peptide, and CD8+ count were p < 0.05.

CONCLUSIONS

We collected data from a single-center case series of 32 hospitalized patients who were critically ill with confirmed COVID-19 in Chengdu, China, and compared data with 67 noncritically ill patients. Elderly patients had chronic underlying diseases, notably cardiovascular disease. Higher C-reactive protein levels, higher levels of myocardial damage, and higher brain natriuretic peptide levels; lower white blood cells, neutrophils, and lymphocytes; and lower CD4 and CD8 counts could be used for early detection and identification of critically ill patients, and dynamic Data observation was more important than at a single moment.

摘要

背景

2019 年 12 月,中国武汉爆发了冠状病毒(COVID-19)疫情。病例数量迅速增加,但有关临床特征的信息仍然有限。

目的

本文描述了 COVID-19 的流行病学和临床特征。早期发现和识别重症患者对于促进科学分类和治疗至关重要。

研究设计

本研究纳入了 2020 年 1 月 16 日至 2 月 20 日期间,在中国成都公共卫生临床医疗中心连续收治的 99 例确诊 COVID-19 的患者的回顾性、单中心病例系列研究。随访的最终日期为 2020 年 2 月 23 日。我们收集并分析了流行病学、人口统计学、临床、实验室、影像学和治疗数据。我们比较了重症患者和非重症患者的结局。

结果

99 例 COVID-19 住院患者中,中位年龄为 49 岁(最小 3 个月,最大 87 岁),51 例(52%)为男性;42 例(42%)有武汉旅行史或居住史,48 例(49%)与新型冠状病毒肺炎患者有密切接触史;41 例(41%)患者有基础疾病。常见症状包括发热(85[86%])、干咳(84[85%])和乏力(72[73%])。我们分析了患者的临床特征。我们用均数±标准差表示计量资料。我们收集了年龄(49.39±18.45 岁)、住院天数(12.32±6.70 天)和实验室指标的数据。我们比较了重症和非重症患者:年龄、C 反应蛋白、高敏肌钙蛋白 T、凝血酶原时间、纤维蛋白降解产物、D-二聚体和 CD4+计数的 p 值均<0.001;而住院天数、白细胞、中性粒细胞、淋巴细胞、肌酸激酶同工酶、肌红蛋白、N 末端脑钠肽和 CD8+计数的 p 值均<0.05。

结论

我们从中国成都的一家中心医院收集了 32 例确诊 COVID-19 并患有严重疾病的住院患者的数据,并将这些数据与 67 例非重症患者进行了比较。老年患者患有慢性基础疾病,特别是心血管疾病。较高的 C 反应蛋白水平、较高的心肌损伤水平和较高的脑钠肽水平;较低的白细胞、中性粒细胞和淋巴细胞计数;以及较低的 CD4 和 CD8 计数可用于早期发现和识别重症患者,且动态数据观察比单次观察更重要。

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