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71例2019冠状病毒病患者的临床特征

Clinical characteristics of 71 patients with coronavirus disease 2019.

作者信息

Xiao Miaomiao, Hou Mingjie, Liu Xuhui, Li Zhe, Zhao Qingxia

机构信息

Sixth Department of Infectious Diseases, Sixth People's Hospital of Zhengzhou, Zhengzhou 450015, China.

出版信息

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2020 Jul 28;45(7):790-796. doi: 10.11817/j.issn.1672-7347.2020.200187.

Abstract

OBJECTIVES

To analyze the clinical characteristics of 71 patients with coronavirus disease 2019 (COVID-19).

METHODS

The general data, epidemiological data, laboratory tests, imaging examinations, and treatment of 71 patients with COVID-19 admitted to the Sixth People's Hospital of Zhengzhou from January 19, 2020 to March 3, 2020 were retrospectively analyzed.

RESULTS

Of the 71 COVID-19 patients, the ages were 4-84 (41.29±15.21) years, 38 (53.5%) patients were male, 33 (46.5%) were female, and 52 (73.2%) were in 22 clusters. The main clinical manifestations were fever (78.9%), cough (64.8%), and sputum (38.0%). The fever was mainly low and moderate, with 49 patients (69.0%) at 37.3-39.0 ℃. Most of the leukocytes, neutrophils, and lymphocytes were normal, accounting for 47 (66.2%), 51 (71.8%), and 51 (71.8%) patients, respectively; a few of them were decreased, accounting for 21 (29.6%), 16 (22.5%), and 20 (28.2%) patients, respectively. There were 38 (53.5%) and 31 (43.7%) patients with the decreased CD4 and CD8 T cell counts, respectively. There were 41 (57.7%), 38 (53.5%), 32 (45.1%), 26(36.6%), 22 (31.0%), 20 (28.2%), 14 (19.7%), 14 (19.7%), and 9 (12.7%) patients with the increased levels of C-reactive protein, erythrocyte sedimentation rate, procalcitonin, fibrinogen,interleukin 6, lactate dehydrogenase,-dimer,alanine aminotransferase, and aspartate aminotransferase, respectively. Of the 71 patients, the lung was involved in 60 (84.5%) patients, the double lung was involved in 47 (66.2%) patients, and the single lung was involved in 13 (18.3%) patients. The course of the disease was long, and the time from symptom onset to the second severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid negative transformation was (17.22±6.34) days.There were no significant differences in the incubation period (=-0.453, >0.05), the complicates (χ=0.042, >0.05), and the time from symptom onset to diagnosis (=-1.330, >0.05) in patients between the non-severe group and the severe group. The onset age, gender, SARS-CoV-2 nucleic acid negative time, lymphocyte count, -dimer, C-reactive protein, total bilirubin, direct bilirubin, lactate dehydrogenase, calcium ion, CD4 T cell count, CD8 T cell count, calcitonin, procalcitonin, and troponin were significantly different between the severe group and the non-severe group (all <0.05). Among the 71 patients, 4 (5.6%) patients were mild, 59 (83.1%) were normal, and 8 (11.3%) were severe or critical.

CONCLUSIONS

The aggregation phenomenon of COVID-19 is obvious. Fever and cough are the main clinical manifestations. White blood cells, neutrophils, and lymphocytes in the most patients in the early onset are normal. Most COVID-19 patients are light and ordinary type, with good prognosis.

摘要

目的

分析71例新型冠状病毒肺炎(COVID-19)患者的临床特征。

方法

回顾性分析2020年1月19日至2020年3月3日收治于郑州市第六人民医院的71例COVID-19患者的一般资料、流行病学资料、实验室检查、影像学检查及治疗情况。

结果

71例COVID-19患者年龄4~84(41.29±15.21)岁,男性38例(53.5%),女性33例(46.5%),52例(73.2%)来自22个聚集性病例。主要临床表现为发热(78.9%)、咳嗽(64.8%)、咳痰(38.0%)。发热以低热和中度热为主,49例患者(69.0%)体温为37.3~39.0℃。多数患者白细胞、中性粒细胞及淋巴细胞正常,分别占47例(66.2%)、51例(71.8%)和51例(71.8%);少数患者降低,分别占21例(29.6%)、16例(22.5%)和20例(28.2%)。CD4和CD8 T细胞计数降低的患者分别有38例(53.5%)和31例(43.7%)。C反应蛋白、红细胞沉降率、降钙素原、纤维蛋白原、白细胞介素6、乳酸脱氢酶、D-二聚体、谷丙转氨酶及谷草转氨酶水平升高的患者分别有41例(57.7%)、38例(53.5%)、32例(45.1%)、26例(36.6%)、22例(31.0%)、20例(28.2%)、14例(19.7%)、14例(19.7%)和9例(12.7%)。71例患者中,60例(84.5%)肺部受累,双肺受累47例(66.2%),单肺受累13例(18.3%)。病程较长,从症状出现到严重急性呼吸综合征冠状病毒2(SARS-CoV-2)核酸转阴时间为(17.22±6.34)天。非重症组与重症组患者潜伏期(t=-0.453,P>0.05)、并发症(χ²=0.042,P>0.05)及症状出现到确诊时间(t=-1.330,P>0.05)差异无统计学意义。重症组与非重症组患者发病年龄、性别、SARS-CoV-2核酸转阴时间、淋巴细胞计数、D-二聚体、C反应蛋白、总胆红素、直接胆红素、乳酸脱氢酶、钙离子、CD4 T细胞计数、CD8 T细胞计数、降钙素、降钙素原及肌钙蛋白差异均有统计学意义(均P<0.05)。71例患者中,4例(5.6%)为轻症,59例(83.1%)为普通型,8例(11.3%)为重症或危重症。

结论

COVID-19聚集现象明显。发热、咳嗽为主要临床表现。多数患者起病初期白细胞、中性粒细胞及淋巴细胞正常。多数COVID-19患者为轻型和普通型,预后良好。

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