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2020 年 3 月至 5 月,美国 11 所学术医疗中心的 COVID-19 成年门诊和住院患者特征。

Characteristics of Adult Outpatients and Inpatients with COVID-19 - 11 Academic Medical Centers, United States, March-May 2020.

出版信息

MMWR Morb Mortal Wkly Rep. 2020 Jul 3;69(26):841-846. doi: 10.15585/mmwr.mm6926e3.

Abstract

Descriptions of coronavirus disease 2019 (COVID-19) in the United States have focused primarily on hospitalized patients. Reports documenting exposures to SARS-CoV-2, the virus that causes COVID-19, have generally been described within congregate settings, such as meat and poultry processing plants (1) and long-term care facilities (2). Understanding individual behaviors and demographic characteristics of patients with COVID-19 and risks for severe illness requiring hospitalization can inform efforts to reduce transmission. During April 15-May 24, 2020, telephone interviews were conducted with a random sample of adults aged ≥18 years who had positive reverse transcription-polymerase chain reaction (RT-PCR) test results for SARS-CoV-2 in outpatient and inpatient settings at 11 U.S. academic medical centers in nine states. Respondents were contacted 14-21 days after SARS-CoV-2 testing and asked about their demographic characteristics, underlying chronic conditions, symptoms experienced on the date of testing, and potential exposures to SARS-CoV-2 during the 2 weeks before illness onset (or the date of testing among those who did not report symptoms at the time of testing). Among 350 interviewed patients (271 [77%] outpatients and 79 [23%] inpatients), inpatients were older, more likely to be Hispanic and to report dyspnea than outpatients. Fewer inpatients (39%, 20 of 51) reported a return to baseline level of health at 14-21 days than did outpatients (64%, 150 of 233) (p = 0.001). Overall, approximately one half (46%) of patients reported known close contact with someone with COVID-19 during the preceding 2 weeks. This was most commonly a family member (45%) or a work colleague (34%). Approximately two thirds (64%, 212 of 333) of participants were employed; only 35 of 209 (17%) were able to telework. These findings highlight the need for screening, case investigation, contact tracing, and isolation of infected persons to control transmission of SARS-CoV-2 infection during periods of community transmission. The need for enhanced measures to ensure workplace safety, including ensuring social distancing and more widespread use of cloth face coverings, are warranted (3).

摘要

对美国 2019 冠状病毒病(COVID-19)的描述主要集中在住院患者身上。记录与 COVID-19 病毒(即 SARS-CoV-2)接触的报告通常在聚集场所中进行,例如肉类和家禽加工厂(1)和长期护理机构(2)。了解 COVID-19 患者的个人行为和人口统计学特征以及需要住院治疗的严重疾病风险,可以为减少传播提供信息。在 2020 年 4 月 15 日至 5 月 24 日期间,在美国 9 个州的 11 所美国学术医疗中心的门诊和住院环境中,对 11 项随机抽样的≥18 岁成年人进行了电话访谈,这些成年人的 SARS-CoV-2 逆转录-聚合酶链反应(RT-PCR)检测结果为阳性。在 SARS-CoV-2 检测后 14-21 天,联系受访者,询问他们的人口统计学特征、潜在的慢性疾病、检测当天的症状以及在发病前 2 周内(或检测时未报告症状的受访者的检测日期)接触 SARS-CoV-2 的潜在风险。在接受采访的 350 名患者中(271 名门诊患者和 79 名住院患者),住院患者年龄较大,更有可能是西班牙裔,并且比门诊患者更有可能报告呼吸困难。在 14-21 天内,报告健康状况恢复到基线水平的住院患者(39%,20 名/51 名)少于门诊患者(64%,150 名/233 名)(p=0.001)。总体而言,大约一半(46%)的患者报告在过去 2 周内与 COVID-19 患者有密切接触。最常见的是家庭成员(45%)或同事(34%)。大约三分之二(64%,212 名/333 名)的参与者有工作;只有 209 名(17%)中的 35 名能够远程工作。这些发现强调了在社区传播期间,需要对 SARS-CoV-2 感染者进行筛查、病例调查、接触者追踪和隔离,以控制感染传播。需要采取更多措施确保工作场所安全,包括确保社交距离和更广泛地使用布面口罩(3)。

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