Department of Liver Diseases, The Third People's Hospital of Shenzhen, National Clinical Research Center for Infectious Disease, the Second Affiliated Hospital of Southern University of Science and Technology , Shenzhen, Guangdong, China.
Department of Infectious Diseases, Southwest Hospital, Third Military Medical University (Army Medical University) , Chongqing, China.
Virulence. 2020 Dec;11(1):1443-1452. doi: 10.1080/21505594.2020.1836894.
The diagnosed COVID-19 cases revealed that the incubation periods (IP) varied a lot among patients. However, few studies had emphasized on the different clinical features and prognosis of patients with different IP. A total of 330 patients with laboratory-confirmed COVID-19 were enrolled and classified into immediate onset group(IP<3 days, I group, 57 cases) and late onset group(IP>10 days, L group, 75 cases) based on IP. The difference of clinical characteristics and prognosis of the two groups were compared. There were more patients with fever in I group than in L group(P = 0.003), and counts of all the total lymphocytes, total T lymphocytes, CD4 + and CD8 + T lymphocytes were significantly different between the two groups(all P < 0.01). Besides, patients in L group had more GGOs in CT scan than I group and there were more patients in I group receiving antibiotic treatment than in L group(P < 0.001). For disease aggravation, the median CT scores were comparable between the two groups, but individually, there were more patients with increased CT score during hospitalization in I group than in L group. The aggravation incidence of CT presentation was 21.1% in I group, significantly higher than L group(8.0%, P = 0.042). Multivariable COX models suggested that IP was the only independent factors for CT aggravation. Conclusively, patients with different IP were different in clinical symptoms, laboratory tests, and CT presentations. Shorter IP was associated with the aggravation of lung involvement in CT scan.
确诊的 COVID-19 病例表明，潜伏期（IP）在患者之间差异很大。然而，很少有研究强调不同潜伏期患者的不同临床特征和预后。共纳入 330 例经实验室确诊的 COVID-19 患者，根据潜伏期分为即刻发病组（IP<3 天，I 组，57 例）和迟发发病组（IP>10 天，L 组，75 例）。比较两组患者的临床特征和预后差异。I 组发热患者多于 L 组（P=0.003），两组间总淋巴细胞计数、总 T 淋巴细胞计数、CD4+和 CD8+T 淋巴细胞计数均有显著差异（均 P<0.01）。此外，L 组患者 CT 扫描中的 GGO 多于 I 组，I 组患者接受抗生素治疗的比例高于 L 组（P<0.001）。对于病情恶化，两组的 CT 评分中位数无差异，但 I 组住院期间 CT 评分增加的患者多于 L 组。I 组 CT 表现恶化的发生率为 21.1%，明显高于 L 组（8.0%，P=0.042）。多变量 COX 模型提示，潜伏期是 CT 恶化的唯一独立因素。综上所述，不同潜伏期的患者在临床症状、实验室检查和 CT 表现方面存在差异。较短的潜伏期与 CT 扫描中肺受累的恶化有关。
