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疑似新型冠状病毒肺炎患者的特征:大流行早期数据的回顾性分析

Profile of Patients Suspected to be COVID-19: A Retrospective Analysis of Early Pandemic Data.

作者信息

Goel Ashish, Raizada Alpana, Bansal Kamakshi, Gaur Nikhil, Abraham Jyotika, Yadav Anil

机构信息

Internal Medicine, University Respati Yogyakarta, Yogyakarta, IDN.

Internal Medicine, University College of Medical Sciences, Delhi, IND.

出版信息

Cureus. 2020 Aug 29;12(8):e10125. doi: 10.7759/cureus.10125.

Abstract

Background and Objectives Coronavirus disease 2019 (COVID-19), a global public health emergency of profound magnitude, has brought life to an unprecedented near-standstill. The clinical profile of the disease is still emerging and is marked by considerable geographical variability in terms of transmissibility, clinical profile, virulence, and mortality of the disease. As clinical data is being reported from around the globe, it becomes important to focus on local subjects in a global milieu, lest one misses the trees for the forest. Our study is a short retrospective analysis of the demographic and clinical profiles of subjects presenting with a mild flu-like illness to our hospital who were tested for COVID-19. It compares the differences in age and sex of those who tested positive with those negative. In addition, it reviews the length of time it might take for a case testing positive on reverse transcriptase-polymerase chain reaction (RT-PCR) test to become negative. Methodology A retrospective analysis of data from adults who presented to our hospital with a mild flu-like illness between the months of March and May 2020 was conducted to understand the disease profile. The nasal/oropharyngeal swabs were collected from each patient and were transported to state-approved laboratories chain for RT-PCR analysis. Information was collected from reports received, clinical information forms, and sample collection forms that were being maintained as a part of the clinical management protocol. Data were analysed using Stata software, version 13 (StataCorp LLC, College Station, TX, USA). Observations and Results Three thousand twenty-six subjects presented to our hospital with either mild flu-like symptoms or with suspected exposure to a confirmed case of COVID-19. The subjects had a mean age of 37.3 (± 15.1) years and 1,805 (60.3%) were males. A regression analysis revealed an adjusted odds of 1.6 (95% confidence interval (CI): 1.2, 2.1) for testing positive for males as compared to females. For every one year increase in age, the odds for testing positive increased by 1.02 (95% CI: 1.01, 1.03). Of the 2,592 individuals for whom data was available, 201 (7.6%) were found positive on RT-PCR analysis. Those testing positive were significantly older (41.0 years vs 36.8 years; p = 0.001) and more likely to be male (number: 138; 9.0% vs 6.7%; p = 0.05). Cough, followed by fever, was a common presenting feature. A survival time analysis using data from 54 participants documented 455 days of the total observation period. A median time of eight days was required for the test to convert from positive to negative if the patient remained mildly symptomatic and did not develop a severe complicated illness. The time to conversion did not differ with age or sex. Conclusions Our analysis shows that patients with COVID-19 have presented with milder symptoms and have recovered well. The low test positivity rate is indicative of the early phase of the pandemic in the country and is a reflection of active infection control measures.

摘要

背景与目的 2019 冠状病毒病(COVID-19)是一场极为严重的全球突发公共卫生事件,已使生活几乎陷入前所未有的停滞状态。该疾病的临床特征仍在显现,其传播性、临床特征、毒力和死亡率在地理上存在显著差异。随着全球各地临床数据的报告,在全球背景下关注本地研究对象变得尤为重要,以免只见树木不见森林。我们的研究是对我院出现轻度流感样疾病并接受 COVID-19 检测的患者的人口统计学和临床特征进行的简短回顾性分析。它比较了检测呈阳性者与阴性者在年龄和性别的差异。此外,还回顾了逆转录聚合酶链反应(RT-PCR)检测呈阳性的病例转为阴性所需的时间。

方法 对 2020 年 3 月至 5 月期间我院出现轻度流感样疾病的成人数据进行回顾性分析,以了解疾病特征。从每位患者采集鼻/咽拭子,并送往国家批准的实验室进行 RT-PCR 分析。从收到的报告、临床信息表和作为临床管理方案一部分保存的样本采集表中收集信息。使用 Stata 软件 13 版(美国德克萨斯州大学站市 StataCorp 有限责任公司)进行数据分析。

观察与结果 3026 名患者因出现轻度流感样症状或疑似接触确诊 COVID-19 病例而到我院就诊。这些患者的平均年龄为 37.3(±15.1)岁,男性 1805 名(60.3%)。回归分析显示,男性检测呈阳性的校正比值比为 1.6(95%置信区间(CI):1.2,2.1),高于女性。年龄每增加一岁,检测呈阳性的几率增加 1.02(95%CI:1.01,1.03)。在可获取数据的 2592 名个体中,RT-PCR 分析发现 201 名(7.6%)呈阳性。检测呈阳性者年龄显著更大(41.0 岁对 36.8 岁;p = 0.001),且更可能为男性(人数:138 名;9.0%对 6.7%;p = 0.05)。咳嗽,其次是发热,是常见的症状表现。对 54 名参与者的数据进行生存时间分析,总观察期为 455 天。如果患者症状轻微且未发展为严重并发症,检测从阳性转为阴性的中位时间为 8 天。转阴时间在年龄和性别上无差异。

结论 我们的分析表明,COVID-19 患者症状较轻且恢复良好。低检测阳性率表明该国处于疫情早期阶段,也是积极感染控制措施的体现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58e0/7523749/90f319ae1a94/cureus-0012-00000010125-i01.jpg

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