Qu Jiajia, Chang Lap Kam, Tang Xinghua, Du Yiming, Yang Xi, Liu Xiangjiao, Han Ping, Xue Yuwen
Department of Pulmonary and Critical Care Medicine, Shandong University Qilu Hospital , Jinan, China.
Department of international student, Shandong University Cheeloo College of Medicine , Jinan, China.
Acta Clin Belg. 2020 Oct;75(5):348-356. doi: 10.1080/17843286.2020.1798668. Epub 2020 Jul 29.
To recognise clinical features of COVID-19 pneumonia and its differences from influenza pneumonia.
246 patients were enrolled into COVID-19 cohort and 120 patients into influenza cohort. All data were collected and analysed retrospectively. The variables under focus included demographic, epidemiological, clinical, laboratory and imaging characteristics of COVID-19 pneumonia and comparison were made with influenza pneumonia.
The COVID-19 cohort included 53.25% female and 46.75% male. Their main symptom was fever; while 28.05% of patients had only initially fever; 21.54% of them remained feverless. After excluding prior kidney diseases, some patients showed abnormal urinalysis (32.11%), elevated blood creatinine (15.04%) and blood urea nitrogen (19.11%). Typical CT features included ground glass opacity, consolidation and band opacity, which could present as characteristic 'bat wing sign'. Our data showed that male, aged 65 or above, smoking, with comorbidities including diabetes, cardiovascular and kidney diseases, would experience more severe COVID-19 pneumonia. In comparison, COVID-19 cohort showed significantly higher incidence of clustering; the influenza cohort showed higher rate of fever. Both cohorts showed reduced lymphocyte numbers; however, 6 influenza patients showed lymphocytes increased, which was statistical significant compared with COVID-19 cohort. Also, influenza cohort displayed higher white blood cell counts and PCT values.
There is no significant gender difference in the incidence of COVID-19 pneumonia. It predominantly affects the lung as well as the kidney. Age, smoking and comorbidities could contribute to disease severity. Although COVID-19 is more infectious, the rate of secondary bacterial infection is lower than influenza.
识别新型冠状病毒肺炎(COVID-19)的临床特征及其与流感肺炎的差异。
将246例患者纳入COVID-19队列,120例患者纳入流感队列。所有数据均进行回顾性收集和分析。重点关注的变量包括COVID-19肺炎的人口统计学、流行病学、临床、实验室和影像学特征,并与流感肺炎进行比较。
COVID-19队列中女性占53.25%,男性占46.75%。他们的主要症状是发热;28.05%的患者最初仅有发热;21.54%的患者无发热。排除既往肾脏疾病后,部分患者出现尿常规异常(32.11%)、血肌酐升高(15.04%)和血尿素氮升高(19.11%)。典型的CT特征包括磨玻璃影、实变和条索状影,可表现为特征性的“蝙蝠翼征”。我们的数据显示,男性、65岁及以上、吸烟、合并糖尿病、心血管疾病和肾脏疾病等合并症的患者,COVID-19肺炎病情更严重。相比之下,COVID-19队列的聚集性发病率显著更高;流感队列的发热率更高。两个队列的淋巴细胞数量均减少;然而,6例流感患者淋巴细胞增多,与COVID-19队列相比有统计学意义。此外,流感队列的白细胞计数和降钙素原(PCT)值更高。
COVID-19肺炎的发病率无明显性别差异。它主要影响肺部和肾脏。年龄、吸烟和合并症可能导致疾病严重程度增加。虽然COVID-19传染性更强,但继发细菌感染率低于流感。