Hu Fuying, Yin Gang, Chen Youping, Song Jiangqin, Ye Maosong, Liu Jie, Chen Cuicui, Song Yuanlin, Tang Xinjun, Zhang Yong
Department of Pulmonary and Critical Care Medicine, The First People's Hospital of Tianmen, Tianmen, China.
Department of General Surgery, The First People's Hospital of Tianmen, Tianmen, China.
Clin Respir J. 2020 Nov;14(11):1067-1075. doi: 10.1111/crj.13243. Epub 2020 Aug 13.
Coronavirus Disease 2019 (COVID-19) has spread worldwide, and it has reached to more than 14.5 million cases. Although Hubei province is the epicenter of China, little is known about epidemiological and clinical features of COVID-19 in other areas in Hubei province around Wuhan. In addition, the virological data, particularly the factors associated with viral shedding of COVID-19 has not been well described.
To describe the epidemiological and clinical features of patients with COVID-19 in Tianmen city, and identify risk factors associated with prolonged viral shedding of COVID-19.
Inpatients with COVID-19 admitted before February 9, 2020 were included. Characteristics were compared between patients with early and late viral RNA shedding. Multivariate cox regression model was used to investigate variables associated with prolonged viral shedding.
One hundred and eighty-three patients were included. About 8.2% patients were categorized as critical degree of severity. All patients received antiviral therapy, with arbidol and interferon being the commonest. About 38.3% and 16.9% patients were treated with corticosteroid and immunoglobulin, respectively. Time from onset to admission (HR = 0.829, P < 0.001), and administration of corticosteroid (HR = 0.496, P = 0.002), arbidol (HR = 2.605, P = 0.008) and oseltamivir (HR = 0.416, P < 0.001) were independently associated with duration of viral shedding.
Symptoms of patients from Tianmen are relatively mild. Treatment should be started as early as possible, but corticosteroid and oseltamivir should be initiated with caution. In addition, clinical trials on arbidol should be conducted to demonstrate its effectiveness.
2019年冠状病毒病（COVID-19）已在全球范围内传播，病例数已超过1450万例。尽管湖北省是中国的疫情中心，但对于武汉周边湖北省其他地区COVID-19的流行病学和临床特征知之甚少。此外，病毒学数据，特别是与COVID-19病毒脱落相关的因素尚未得到充分描述。
描述天门市COVID-19患者的流行病学和临床特征，并确定与COVID-19病毒长期脱落相关的危险因素。
纳入2020年2月9日前收治的COVID-19住院患者。比较病毒RNA早期和晚期脱落患者的特征。采用多变量cox回归模型研究与病毒长期脱落相关的变量。
共纳入183例患者。约8.2%的患者被分类为危重程度。所有患者均接受抗病毒治疗，其中阿比多尔和干扰素最为常用。分别有38.3%和16.9%的患者接受了皮质类固醇和免疫球蛋白治疗。发病至入院时间（HR = 0.829，P < 0.001）、皮质类固醇给药（HR = 0.496，P = 0.002）、阿比多尔（HR = 2.605，P = 0.008）和奥司他韦（HR = 0.416，P < 0.001）与病毒脱落持续时间独立相关。
天门患者症状相对较轻。应尽早开始治疗，但使用皮质类固醇和奥司他韦时应谨慎。此外，应开展关于阿比多尔的临床试验以证明其有效性。
