Department of Pathology, Yangtze University Health Science Center, Jingzhou, Hubei, P.R. China.
Eur Rev Med Pharmacol Sci. 2020 Jul;24(14):7826-7833. doi: 10.26355/eurrev_202007_22287.
The outbreak of the 2019 Novel Coronavirus Disease (COVID-19) is seriously threatening the health of people all over China and the world. This study aims to investigate the clinical characteristics and outcomes of COVID-19 patients admitted at different time periods.
A total of 132 discharged cases and 10 deaths of laboratory or clinically confirmed cases were retrospectively collected from The First People's Hospital of Jingzhou, Hubei. All cases were divided into two groups according to different admission times (group 1 from 2020-1-23 to 2020-2-3 and group 2 from 2020-2-4 to 2020-2-15). Individual data, clinical data, laboratory indices and prognosis were collected for the two groups, and statistical analysis was performed using the t-test or chi-square test to assess differences between the groups.
Among the 142 cases, there were 67 in the first group and 75 in the second group. According to the individual data and clinical manifestations of the two groups, the hospital stay in the first group was significantly longer than that of the second group (26 [9-39] compared with 20 [6-30], p=0.000). There were more clinical symptoms upon admission in group 1 than in group 2; although 66.2% of all patients had fever, the proportion of patients with fever on admission in the first group was significantly higher than that in the second group (79.1% compared with 54.7%, p=0.002). The proportion of patients with chills in the first group was higher than that in the second group (16.4% compared with 5.3%, p=0.032), and the proportion of patients with dyspnea was also higher than that in the second group (17.9% compared with 4%, p=0.007). Four of the 67 patients in the first group had symptoms of ocular discomfort, but none in the second group had this symptom (6.0% compared with 0, p=0.032). Based on laboratory examination, the inflammatory index of patients in the first group was higher than that in the second group, and the proportion of patients with a C-reactive protein (CRP) increase was also significantly higher (60% compared with 38.7%, p=0.020). The main difference in routine blood tests involved white blood cell and lymphocyte counts and the lymphocyte percentage. The proportion of patients with reduced white blood cell counts in the first group was higher than that in the second group (23.9% compared with 10.7% p=0.036). Moreover, more patients in the first group had a reduced lymphocyte count and percentage (71.6% compared with 30.7% p=0.000; 49.3% compared with 29.7% p=0.015, respectively), and the former was significantly lower than that in the second group (0.94 [0.24-2.42] compared with 1.365 [0.22-3.62], p=0.000). Regarding prognosis, the proportion of severe cases and mortality in the first group were slightly higher than in the second group (p>0.05).
The clinical manifestations, blood changes and outcomes differed in patients admitted at different time periods. In the second group of patients, clinical symptoms were less common than in the first group, routine blood changes and inflammatory indices were milder, and the clinical prognosis was better.
2019 年新型冠状病毒病（COVID-19）的爆发严重威胁着全中国和世界人民的健康。本研究旨在探讨不同时期住院的 COVID-19 患者的临床特征和转归。
回顾性收集了荆州市第一人民医院 132 例出院和 10 例临床或实验室确诊病例，所有病例均根据不同入院时间分为两组（第 1 组：2020-1-23 至 2020-2-3；第 2 组：2020-2-4 至 2020-2-15）。收集两组个体数据、临床数据、实验室指标和预后，并使用 t 检验或卡方检验进行统计分析，以评估两组间的差异。
在 142 例病例中，第 1 组 67 例，第 2 组 75 例。根据两组个体数据和临床表现，第 1 组的住院时间明显长于第 2 组（26 [9-39] 与 20 [6-30]，p=0.000）。第 1 组入院时的临床症状更多；虽然所有患者均有发热，但第 1 组发热患者的比例明显高于第 2 组（79.1%比 54.7%，p=0.002）。第 1 组寒战患者的比例高于第 2 组（16.4%比 5.3%，p=0.032），呼吸困难患者的比例也高于第 2 组（17.9%比 4%，p=0.007）。第 1 组 67 例患者中有 4 例出现眼部不适症状，但第 2 组无一例出现该症状（6.0%比 0%，p=0.032）。根据实验室检查，第 1 组患者的炎症指标高于第 2 组，C 反应蛋白（CRP）升高的患者比例也明显更高（60%比 38.7%，p=0.020）。常规血液检查的主要差异涉及白细胞和淋巴细胞计数以及淋巴细胞百分比。第 1 组白细胞计数减少的患者比例高于第 2 组（23.9%比 10.7%，p=0.036）。此外，第 1 组更多的患者出现淋巴细胞计数和百分比减少（71.6%比 30.7%，p=0.000；49.3%比 29.7%，p=0.015），前者明显低于第 2 组（0.94 [0.24-2.42] 比 1.365 [0.22-3.62]，p=0.000）。关于预后，第 1 组严重病例和死亡率的比例略高于第 2 组（p>0.05）。
不同时期住院的患者临床表现、血液变化和预后不同。第 2 组患者的临床症状较第 1 组少见，常规血液变化和炎症指标较轻，临床预后较好。
