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421 例在方舱医院接受治疗的新型冠状病毒病患者的临床特征和转归。

Clinical Characteristics and Outcomes of 421 Patients With Coronavirus Disease 2019 Treated in a Mobile Cabin Hospital.

机构信息

Department of Respiratory and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China.

Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China.

出版信息

Chest. 2020 Sep;158(3):939-946. doi: 10.1016/j.chest.2020.05.515. Epub 2020 May 8.

Abstract

BACKGROUND

In December 2019, a novel coronavirus-associated pneumonia, now known as coronavirus disease 2019 (COVID-19), was first detected in Wuhan, China. To prevent the rapid spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and treat patients with mild symptoms, sports stadiums and convention centers were reconstructed into mobile hospitals.

RESEARCH QUESTION

It is unknown whether a mobile cabin hospital can provide a safe treatment site for patients with mild COVID-19 symptoms.

STUDY DESIGN AND METHODS

This study retrospectively reviewed the medical records of 421 patients with COVID-19 admitted to a mobile cabin hospital in Wuhan from February 9, 2020, to March 5, 2020. Clinical data comprised patient age, sex, clinical presentation, chest imaging, nucleic acid testing, length of hospitalization, and outcomes.

RESULTS

Of the patients who were discharged from the cabin hospital, 362 (86.0%) were categorized as recovered; 14.0% developed severe symptoms and were transferred to a designated hospital. The most common presenting symptoms were fever (60.6%) and cough (52.0%); 5.2% exhibited no obvious symptoms. High fever (> 39.0°C) was more common in severe cases than in recovered cases (18.6% vs 6.6%). The distribution of lung lesions was peripheral in 85.0% of patients, multifocal in 69.4%, and bilateral in 68.2%. The most common pattern was ground-glass opacity (67.7%), followed by patchy shadowing (49.2%). The incidence of patchy shadowing was higher in patients with severe disease (66.1%) than in those who recovered (31.8%,  < .0001). The median length of hospitalization was 17 days (interquartile range, 14-19 days), and the median time taken for positive real-time reverse transcriptase polymerase chain reaction results to become negative in recovered patients was 8 days (interquartile range, 6-10 days).

INTERPRETATION

Mobile cabin hospitals provide a safe treatment site for patients with mild COVID-19 symptoms and offer an effective isolation area to prevent the spread of severe acute respiratory syndrome coronavirus 2.

摘要

背景

2019 年 12 月,在中国武汉首次发现一种新型冠状病毒相关肺炎,现称为 2019 年冠状病毒病(COVID-19)。为了防止严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)的迅速传播和治疗轻症患者,体育场和会议中心被改建成移动医院。

研究问题

目前尚不清楚移动方舱医院是否可为轻症 COVID-19 症状患者提供安全的治疗场所。

研究设计和方法

本研究回顾性分析了 2020 年 2 月 9 日至 3 月 5 日期间入住武汉一家移动方舱医院的 421 例 COVID-19 患者的病历。临床数据包括患者年龄、性别、临床表现、胸部影像学、核酸检测、住院时间和结局。

结果

从方舱医院出院的患者中,362 例(86.0%)被归类为痊愈;14.0%的患者出现严重症状并转至指定医院。最常见的症状是发热(60.6%)和咳嗽(52.0%);5.2%的患者无症状。高热(>39.0°C)在重症患者中比在痊愈患者中更为常见(18.6%比 6.6%)。肺部病变的分布在 85.0%的患者中为外周性,在 69.4%的患者中为多灶性,在 68.2%的患者中为双侧性。最常见的模式是磨玻璃样混浊(67.7%),其次是斑片状阴影(49.2%)。重症患者的斑片状阴影发生率高于痊愈患者(66.1%比 31.8%,<0.0001)。中位住院时间为 17 天(四分位距,14-19 天),痊愈患者的实时逆转录聚合酶链反应结果转为阴性的中位时间为 8 天(四分位距,6-10 天)。

结论

移动方舱医院可为轻症 COVID-19 症状患者提供安全的治疗场所,并为防止严重急性呼吸系统综合征冠状病毒 2 的传播提供有效的隔离区。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4bba/7207119/ae09ef2d6d8c/gr1_lrg.jpg

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