Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; Department of Respiratory, The First Hospital of Jiaxing (The Affiliated Hospital of Jiaxing University), Jiaxing, China.
Clin Microbiol Infect. 2020 Oct;26(10):1380-1385. doi: 10.1016/j.cmi.2020.06.018. Epub 2020 Jun 25.
The aim was to determine the clinical characteristics of COVID-19 patients because the SARS-CoV-2 virus continues to circulate in the population.
This is a retrospective, multicentre, cohort study. Adult COVID-19 cases from four hospitals in Zhejiang were enrolled and clustered into three groups based on epidemiological history. First-generation patients had a travel history to Hubei within 14 days before disease onset; second-generation patients had a contact history with first-generation patients; third-generation patients had a contact history with second-generation patients. Demographic, clinical characteristics, clinical outcomes and duration of viral shedding were analysed.
A total of 171 patients were enrolled, with 83, 44 and 44 patients in the first-, second-, and third-generation, respectively. Compared with the first and second generations, third-generation patients were older (61.3 vs. 48.3 and 44.0 years, p < 0.001) and had more coexisting conditions (56.8% vs. 36.1% and 27.3%, p 0.013). At 7 ± 1 days from illness onset, third-generation patients had lower lymphocyte (0.6 vs. 0.8 and 0.8 × 109/L, p 0.007), higher C-reactive protein (29.7 vs. 17.1 and 13.8 mg/L, p 0.018) and D-dimer (1066 vs. 412.5 and 549 μg/L, p 0.002) and more lesions involving the pulmonary lobes (lobes ≥5, 81.8% vs. 53.0% and 34.1%, p < 0.001). The proportions of third-generation patients developing severe illness (72.7% vs. 32.5% and 27.3%, p < 0.001), critical illness (38.6% vs. 10.8% and 6.8%, p < 0.001) and receiving endotracheal intubation (20.5% vs. 3.6% and 2.3%, p 0.002) were higher than in the other two groups.
Third-generation patients were older, had more underlying comorbidities and had a higher proportion of severe or critical illness than first- and second-generation patients.
由于 SARS-CoV-2 病毒仍在人群中传播，本研究旨在确定 COVID-19 患者的临床特征。
这是一项回顾性、多中心、队列研究。纳入来自浙江 4 家医院的成年 COVID-19 病例，并根据流行病学史将其分为 3 组。第一代患者在发病前 14 天内有湖北旅行史；第二代患者有与第一代患者的接触史；第三代患者有与第二代患者的接触史。分析人口统计学、临床特征、临床结局和病毒脱落持续时间。
共纳入 171 例患者，第一代、第二代和第三代患者分别为 83、44 和 44 例。与第一代和第二代相比，第三代患者年龄更大（61.3 岁比 48.3 岁和 44.0 岁，p<0.001），合并症更多（56.8%比 36.1%和 27.3%，p<0.013）。发病后 7±1 天，第三代患者的淋巴细胞（0.6 比 0.8 和 0.8×109/L，p<0.007）更低，C 反应蛋白（29.7 比 17.1 和 13.8 mg/L，p<0.018）和 D-二聚体（1066 比 412.5 和 549 μg/L，p<0.002）更高，肺叶受累（≥5 个肺叶，81.8%比 53.0%和 34.1%，p<0.001）更多。第三代患者发生重症（72.7%比 32.5%和 27.3%，p<0.001）、危重症（38.6%比 10.8%和 6.8%，p<0.001）和接受气管插管（20.5%比 3.6%和 2.3%，p<0.002）的比例高于其他两组。
第三代患者年龄更大，合并症更多，重症或危重症的比例高于第一代和第二代患者。
