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中国上海 161 例新冠肺炎出院患者的流行病学和临床特征。

Epidemiological and clinical characteristics of 161 discharged cases with coronavirus disease 2019 in Shanghai, China.

机构信息

Shanghai Municipal Center for Disease Control and Prevention, No. 1380, West Zhongshan Road, Shanghai, 200336, China.

出版信息

BMC Infect Dis. 2020 Oct 20;20(1):780. doi: 10.1186/s12879-020-05493-7.

Abstract

BACKGROUND

In December 2019, the outbreak of coronavirus disease 2019 (COVID-19) began in Wuhan, China, and rapidly spread to other regions. We aimed to further describe the epidemiological and clinical characteristics of discharged COVID-19 cases and evaluate the public health interventions.

METHODS

We collected epidemiological and clinical data of all discharged COVID-19 cases as of 17 February 2020 in Shanghai. The key epidemiological distributions were estimated and outcomes were also compared between patients whose illness were before 24 January and those whose illness were after 24 January.

RESULTS

Of 161 discharged COVID-19 cases, the median age was 45 years, and 80 (49.7%) cases were male. All of the cases were categorized as clinical moderate type. The most common initial symptoms were fever (85.7%), cough (41.0%), fatigue (19.3%), muscle ache (17.4%), sputum production (14.9%), and there were six asymptomatic cases. 39 (24.2%) cases got infected in Shanghai, and three of them were second-generation cases of Shanghai native cases. The estimated median of the time from onset to first medical visit, admission, disease confirmation, and discharge for 161 cases was 1.0 day (95% CI, 0.6-1.2), 2.0 days (95% CI, 1.5-2.6), 5.2 days (95% CI, 4.6-5.7), 18.1 days (95% CI, 17.4-18.8), respectively. The estimated median of the time from admission to discharge was 14.0 days (95% CI, 13.3-14.6). The time from onset to first medical visit, admission and disease confirmation were all shortened after the Shanghai's first-level public health emergency response. In Cox regression model, the significant independent covariates for the duration of hospitalization were age, the time from onset to admission and the first-level public health emergency response.

CONCLUSIONS

Local transmission had occurred in Shanghai in late January 2020. The estimated median of the time from onset to discharge of moderate COVID-19 was 18.1 days in Shanghai. Time intervals from onset to first medical visit, admission and disease confirmation were all shortened after the Shanghai's first-level public health emergency response. Age, the first-level public health emergency response and the time from onset to admission were the impact factors for the duration of hospitalization.

摘要

背景

2019 年 12 月,新型冠状病毒病 2019(COVID-19)疫情在中国武汉爆发,并迅速蔓延至其他地区。本研究旨在进一步描述已出院 COVID-19 病例的流行病学和临床特征,并评估公共卫生干预措施的效果。

方法

我们收集了截至 2020 年 2 月 17 日上海所有已出院 COVID-19 病例的流行病学和临床数据。估计了关键的流行病学分布,并比较了发病日期早于 2020 年 1 月 24 日和晚于 2020 年 1 月 24 日的两组患者的结局。

结果

在 161 例出院的 COVID-19 病例中,中位年龄为 45 岁,80 例(49.7%)为男性。所有病例均为临床中度。最常见的初始症状是发热(85.7%)、咳嗽(41.0%)、乏力(19.3%)、肌肉酸痛(17.4%)、咳痰(14.9%),有 6 例无症状病例。39 例(24.2%)病例在上海感染,其中 3 例为上海本地病例的二代病例。估计 161 例患者从发病到首次就诊、入院、确诊和出院的中位时间分别为 1.0 天(95%CI,0.6-1.2)、2.0 天(95%CI,1.5-2.6)、5.2 天(95%CI,4.6-5.7)、18.1 天(95%CI,17.4-18.8)。从入院到出院的中位时间为 14.0 天(95%CI,13.3-14.6)。上海启动一级公共卫生应急响应后,首次就诊、入院和确诊的时间均缩短。在 Cox 回归模型中,年龄、发病至入院时间和一级公共卫生应急响应是住院时间的显著独立协变量。

结论

2020 年 1 月下旬,上海已发生本地传播。上海中度 COVID-19 患者从发病到出院的中位时间估计为 18.1 天。上海启动一级公共卫生应急响应后,从发病到首次就诊、入院和确诊的时间间隔均缩短。年龄、一级公共卫生应急响应和发病至入院时间是影响住院时间的因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1eb/7576849/7679128ff9f2/12879_2020_5493_Fig1_HTML.jpg

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