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印度尼西亚雅加达一家二级医院中新冠肺炎患者的临床、放射学特征及转归

Clinical, Radiological Features and Outcome of COVID-19 patients in a Secondary Hospital in Jakarta, Indonesia.

作者信息

Hafiz Muhammad, Icksan Aziza Ghanie, Harlivasari Annisa Dian, Aulia Rizky, Susanti Febrina, Eldinia Lourisa

机构信息

Department of Pulmonology and Respiratory Medicine, Budhi Asih Hospital, Jakarta, Indonesia.

Department of Radiology, Faculty of Medicine University Pembangunan Nasional, Persahabatan Hospital, Jakarta, Indonesia.

出版信息

J Infect Dev Ctries. 2020 Jul 31;14(7):750-757. doi: 10.3855/jidc.12911.

Abstract

INTRODUCTION

The numbers of people infected with SARS-CoV-2 in Indonesia especially in Jakarta as the epicenter continue to rise. Limited published clinical data, scarcity and long turn over time of diagnostic testing put clinician in dilemma to make diagnosis.

METHODOLOGY

This is an observational case series study from confirmed COVID-19 patient in our hospital from first case admission on 17 March 30 April, 2020. We collected patient's demography, symptoms, comorbidities, therapy, laboratory, chest x-ray and ECG consecutively.

RESULTS

Between 17 March 2020 and 30 April 2020, there were 30 confirmed COVID-19 cases, 16 (53.3%) were male. Clinical symptoms were dyspnea in 22 (73.3%) and dry cough 16 (53.3%). Comorbidities were diabetes in 14 (46.6%), hypertension 10 (33.3%) and Coronary Artery Disease (CAD) in 10 (33.3%) patients respectively. Laboratory findings showed lymphopenia in 21 (70%) patients, increased inflammation marker in Erythrocyte Sedimentation Rate (ESR), C-Reactive Protein (CRP) and Lactate Dehydrogenase (LDH) 21 (70%), 23 (76.6%) and 12 (40%) patients respectively. Twenty-seven (90%) cases had abnormal Chest X-Ray (CXR) and mostly severe 18 (60%). Descriptive finding for images included consolidation 16 (53.3%) and Ground Glass Opacities (GGO) in 10 (33.3%) patients.

CONCLUSIONS

Based on our findings, most cases of COVID-19 admitted in secondary referral hospital were already in moderate to severe stages. This is most likely due to late referral from primary care and unspecific clinical features resemblance of other infectious diseases. Inflammation marker and CXR are cost effective findings and can be used as marker to determine further referral.

摘要

引言

印度尼西亚尤其是作为疫情中心的雅加达,感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的人数持续上升。已发表的临床数据有限,诊断检测稀缺且周转时间长,这使临床医生在做出诊断时陷入两难境地。

方法

这是一项观察性病例系列研究,研究对象为2020年3月17日首例入院至4月30日期间我院确诊的新型冠状病毒肺炎(COVID-19)患者。我们连续收集了患者的人口统计学信息、症状、合并症、治疗情况、实验室检查结果、胸部X线和心电图。

结果

2020年3月17日至4月30日期间,共有30例确诊的COVID-19病例,其中16例(53.3%)为男性。临床症状方面,22例(73.3%)出现呼吸困难,16例(53.3%)出现干咳。合并症方面,分别有14例(46.6%)患有糖尿病,10例(33.3%)患有高血压,10例(33.3%)患有冠状动脉疾病(CAD)。实验室检查结果显示,21例(70%)患者出现淋巴细胞减少,21例(70%)、23例(76.6%)和12例(40%)患者的红细胞沉降率(ESR)、C反应蛋白(CRP)和乳酸脱氢酶(LDH)等炎症标志物升高。27例(90%)病例胸部X线(CXR)异常,其中18例(60%)为重度异常。图像描述性结果包括16例(53.3%)出现实变,10例(33.3%)出现磨玻璃影(GGO)。

结论

根据我们的研究结果,二级转诊医院收治的大多数COVID-19病例已处于中重度阶段。这很可能是由于基层医疗转诊延迟以及与其他传染病相似的非特异性临床特征所致。炎症标志物和CXR是具有成本效益的检查结果,可作为确定进一步转诊的指标。

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