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COVID-19 患者恢复期的流行病学特征。

Epidemiological characteristics of COVID-19 patients in convalescence period.

机构信息

Department of Nephrology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.

Department of Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.

出版信息

Epidemiol Infect. 2020 Jun 3;148:e108. doi: 10.1017/S0950268820001181.

Abstract

This study aimed to investigate the clinical characteristics and to analyse the epidemiological features of coronavirus disease 2019 (COVID-19) patients during convalescence. In this study, we enrolled 71 confirmed cases of COVID-19 who were discharged from hospital and transferred to isolation wards from 6 February to 26 March 2020. They were all employees of Zhongnan Hospital of Wuhan University or their family members of which three cases were <18 years of age. Clinical data were collected and analysed statistically. Forty-one cases (41/71, 57.7%) comprised medical faculty, young and middle-aged patients (aged ⩽60 years) accounted for 81.7% (58/71). The average isolation time period for all adult patients was 13.8 ± 6.1 days. During convalescence, RNA detection results of 35.2% patients (25/71) turned from negative to positive. The longest RNA reversed phase time was 7 days. In all, 52.9% of adult patients (36/68) had no obvious clinical symptoms, and the remaining ones had mild and non-specific clinical symptoms (e.g. cough, sputum, sore throat, disorders of the gastrointestinal tract etc.). Chest CT signs in 89.7% of adult patients (61/68) gradually improved, and in the others, the lesions were eventually absorbed and improved after short-term repeated progression. The main chest CT manifestations of adult patients were normal, GGO or fibre streak shadow, and six patients (8.8%) had extrapulmonary manifestations, but there was no significant correlation with RNA detection results (r = -0.008, P > 0.05). The drug treatment was mainly symptomatic support therapy, and antibiotics and antiviral drugs were ineffective. It is necessary to re-evaluate the isolation time and standard to terminate isolation for discharged COVID-19 patients.

摘要

这项研究旨在调查新冠肺炎(COVID-19)患者恢复期的临床特征,并分析其流行病学特征。在这项研究中,我们纳入了 2020 年 2 月 6 日至 3 月 26 日从医院出院并转入隔离病房的 71 例确诊 COVID-19 患者,他们均为武汉大学中南医院的员工或其家庭成员,其中 3 例年龄<18 岁。收集临床资料并进行统计学分析。41 例(41/71,57.7%)为医护人员,中青年患者(≤60 岁)占 81.7%(58/71)。所有成年患者的平均隔离时间为 13.8±6.1 天。在恢复期,35.2%患者(25/71)的 RNA 检测结果由阴性转为阳性,最长逆转时间为 7 天。共有 52.9%(36/68)成年患者无明显临床症状,其余患者有轻度且无特异性的临床症状(如咳嗽、咳痰、咽痛、胃肠道紊乱等)。89.7%成年患者(61/68)的胸部 CT 征象逐渐改善,其余患者的病变在短期反复进展后最终吸收改善。成年患者的主要胸部 CT 表现为正常、磨玻璃样影或纤维条索影,6 例(8.8%)有肺外表现,但与 RNA 检测结果无显著相关性(r=-0.008,P>0.05)。药物治疗主要为对症支持治疗,抗生素和抗病毒药物无效。有必要重新评估出院 COVID-19 患者的隔离时间和标准,以终止隔离。

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