1054 名因疑似 COVID-19 住院的成年人的临床特征、症状和转归：伴有和不伴有 SARS-CoV-2 感染患者的比较。
Clinical characteristics, symptoms and outcomes of 1054 adults presenting to hospital with suspected COVID-19: A comparison of patients with and without SARS-CoV-2 infection.
机构信息
School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK; Department of Infection, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK; Department of Infection, University Hospital Southampton NHS Foundation Trust, Southampton, UK; NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS, Foundation Trust, Southampton, UK.
出版信息
J Infect. 2020 Dec;81(6):937-943. doi: 10.1016/j.jinf.2020.09.033. Epub 2020 Sep 28.
OBJECTIVES
Most reports describing the characteristics of patients hospitalised with COVID-19 lack a comparator group. We compared clinical characteristics, symptoms, and outcomes of adults presenting to hospital during the pandemic first wave, who tested positive and negative for SARS-CoV-2.
METHODS
Detailed patient data was obtained from a large, controlled, non-randomised trial of molecular point-of-care testing versus laboratory RT-PCR for SARS-CoV-2 in adults presenting to a large UK hospital with suspected COVID-19.
RESULTS
1054 patients were included: 352 (33.4%) tested positive and 702 (66.6%) negative. 13.4% (47/352) COVID-19-positive patients had COPD versus 18.7% (131/702) of COVID-19-negative patients (difference=5.3% [95%CI -9.7% to -0.5%], p = 0.0297). 5.7% (20/352) of COVID-19-positive patients were smokers versus 16.5% (116/702) of negative patients (difference=-10.8% [-14.4% to -7.0%], p = 0.0001). 70.5% (248/352) of COVID-19-positive patients were White-British versus 85.5% (600/702) of negative patients (difference=-15.0% [-20.5% to -9.7%], p<0.0001). 20.9% (39/187) of COVID-19-positive patients were healthcare workers versus 5.2% (15/287) of negative patients (p<0.0001). Anosmia was reported in 33.1% (47/142) versus 8.8% (19/216) of COVID-19-positive and negative patients respectively (p<0.0001). Non-SARS-CoV-2 respiratory viruses or atypical bacteria were detected in 2.5% (5/197) of COVID-19 patients versus 7.9% (24/302) of COVID-19-negative patients (p = 0.0109). Hospitalisation duration and 30-day-mortality were higher in COVID-19 patients and invasive ventilation was more frequent (11.1% vs 2.8%, p<0.0001), and longer (14.5 vs 4.7 days, p = 0.0015).
CONCLUSIONS
There were substantial differences between patients with and without COVID-19 in terms of ethnicity, healthcare worker-status, comorbidities, symptoms, and outcomes. These data can inform healthcare planning for the next phase of the pandemic.
目的
大多数描述 COVID-19 住院患者特征的报告缺乏对照组。我们比较了大流行第一波期间因疑似 COVID-19 而住院的成年人中 SARS-CoV-2 检测阳性和阴性患者的临床特征、症状和结局。
方法
详细的患者数据来自一项大型、对照、非随机试验，该试验比较了用于 SARS-CoV-2 的分子即时检测与实验室 RT-PCR 在出现疑似 COVID-19 症状的英国大型医院就诊的成年人中的应用。
结果
共纳入 1054 例患者：352 例（33.4%）检测阳性，702 例（66.6%）检测阴性。COVID-19 阳性患者中有 13.4%（47/352）患有 COPD，而 COVID-19 阴性患者中有 18.7%（131/702）患有 COPD（差异=5.3%[-9.7%至-0.5%]，p=0.0297）。COVID-19 阳性患者中有 5.7%（20/352）为吸烟者，而 COVID-19 阴性患者中有 16.5%（116/702）为吸烟者（差异=-10.8%[-14.4%至-7.0%]，p=0.0001）。COVID-19 阳性患者中有 70.5%（248/352）为白种英国人，而 COVID-19 阴性患者中有 85.5%（600/702）为白种英国人（差异=-15.0%[-20.5%至-9.7%]，p<0.0001）。COVID-19 阳性患者中有 20.9%（39/187）为医护人员，而 COVID-19 阴性患者中有 5.2%（15/287）为医护人员（p<0.0001）。COVID-19 阳性患者中有 33.1%（47/142）报告有嗅觉丧失，而 COVID-19 阴性患者中有 8.8%（19/216）报告有嗅觉丧失（p<0.0001）。COVID-19 患者中有 2.5%（5/197）检测到非 SARS-CoV-2 呼吸道病毒或非典型细菌，而 COVID-19 阴性患者中有 7.9%（24/302）检测到非 SARS-CoV-2 呼吸道病毒或非典型细菌（p=0.0109）。COVID-19 患者的住院时间和 30 天死亡率较高，需要侵入性通气的情况更为常见（11.1%比 2.8%，p<0.0001），且时间更长（14.5 比 4.7 天，p=0.0015）。
结论
COVID-19 患者与非 COVID-19 患者在种族、医护人员身份、合并症、症状和结局方面存在显著差异。这些数据可以为下一个大流行阶段的医疗保健规划提供信息。
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