Department of Infectious Disease, The Fourth People's Hospital of Qinghai Province, Xining, Qinghai, China.
Department of Medicine, The Third People's Hospital of Xining, Xining, Qinghai, China.
J Med Virol. 2020 Nov;92(11):2528-2535. doi: 10.1002/jmv.26032. Epub 2020 Jul 28.
Since the outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in Wuhan, a series of confirmed cases of COVID-19 were found on the Qinghai-Tibet plateau. We aimed to describe the epidemiological, clinical characteristics, and outcomes of all confirmed cases in Qinghai, a province at high altitude. The region had no sustained local transmission. Of all 18 patients with confirmed SARS-CoV-2 infection, 15 patients comprising four transmission clusters were identified. Three patients were infected by direct contact without travel history to Wuhan. Of 18 patients, 10 patients showed bilateral pneumonia and two patients showed no abnormalities. Three patients with comorbidities such as hypertension, liver diseases, or diabetes developed severe illness. High C-reactive protein levels and elevations of both alanine aminotransferase and aspartate aminotransferase were observed in three severely ill patients on admission. All 18 patients were eventually discharged, including the three severe patients who recovered after treatment with noninvasive mechanical ventilation, convalescent plasma, and other therapies. Our findings confirmed human-to-human transmission of SARS-CoV-2 in clusters. Patients with comorbidities are more likely to develop severe illness.
自 2019 年冠状病毒病(COVID-19)爆发以来,由严重急性呼吸系统综合症冠状病毒 2(SARS-CoV-2)引起的 COVID-19 已在武汉首次报告,在青藏高原上发现了一系列确诊的 COVID-19 病例。我们旨在描述在高海拔省份青海的所有确诊病例的流行病学、临床特征和结局。该地区没有持续的本地传播。在所有 18 例确诊的 SARS-CoV-2 感染患者中,发现了 15 例患者,其中包括 4 个传播集群。其中 3 名患者在没有前往武汉旅行史的情况下通过直接接触感染。在 18 例患者中,10 例患者表现为双侧肺炎,2 例患者无异常。3 例合并高血压、肝脏疾病或糖尿病的患者病情严重。3 名重症患者入院时 C 反应蛋白水平较高,丙氨酸氨基转移酶和天冬氨酸氨基转移酶均升高。所有 18 例患者最终出院,包括 3 名接受无创机械通气、恢复期血浆和其他治疗后康复的重症患者。我们的研究结果证实了 SARS-CoV-2 在集群中的人际传播。合并症患者更有可能发展为重症。