前往发热门诊就诊的患有危及生命疾病的非新冠肺炎患者:日本东京的一项单中心观察性研究
Non-COVID-19 Patients with Life-threatening Diseases Who Visited a Fever Clinic: A Single-center, Observational Study in Tokyo, Japan.
作者信息
Akiyama Yutaro, Morioka Shinichiro, Wakimoto Yuji, Kawashima Akira, Kanda Kohei, Okuhama Ayako, Suzuki Tetsuya, Miyazato Yusuke, Nomoto Hidetoshi, Ide Satoshi, Nakamoto Takato, Nakamura Keiji, Ota Masayuki, Moriyama Yuki, Takaya Saho, Yamada Kota, Taguchi Maho, Sugito Erika, Izuka Shinji, Ishiguro Kenji, Kobayashi Toshiaki, Miyake Wataru, Kubota Shuji, Ishikane Masahiro, Kinoshita Noriko, Yamamoto Kei, Ujiie Mugen, Kutsuna Satoshi, Hayakawa Kayoko, Saito Sho, Ohmagari Norio
机构信息
Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan.
Emerging and Reemerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Japan.
出版信息
Intern Med. 2020 Dec 15;59(24):3131-3133. doi: 10.2169/internalmedicine.5614-20. Epub 2020 Nov 2.
Objective In fever clinics screening coronavirus disease (COVID-19), there could be patients with life-threatening diseases that physicians should not overlook. We exploratorily investigated the final diagnosis among non-COVID-19 hospitalized patients who visited the fever clinic. Methods This was a retrospective, observational, and single-centered study conducted in the National Center for Global Health and Medicine (NCGM), Tokyo, Japan. We conducted a retrospective chart review of patients who visited the fever clinic in the NCGM from 11 March 2020 to 24 April 2020. Patients Patients who met the following clinical criteria visited the fever clinic in the NCGM: (1) body temperature >37.5°C, (2) any symptoms consistent with COVID-19 or (3) referral from local healthcare facilities. In the fever clinic, all patients who met the above criteria had severe acute respiratory syndrome coronavirus 2 polymerase chain reaction test with nasopharyngeal swab specimens. Patients with severe symptoms or an unstable condition were sent to an outpatient clinic for infectious diseases for further evaluation and treatment. Results Among 1,470 patients who visited the fever clinic, 84 patients were hospitalized, and 45 of them were diagnosed as having COVID-19. Among the remaining 39 non-COVID-19 patients, there were nine patients with life-threatening diseases. The life-threatening diseases included acute heart failure, septic shock, pneumocystis pneumonia, peritonsillar abscess, and necrotizing fasciitis. Conclusion Physicians should evaluate each patient carefully while considering other life-threatening conditions even in such a COVID-19 pandemic era.
目的 在发热门诊筛查冠状病毒病(COVID-19)时,可能存在一些危及生命的疾病患者,医生不应忽视。我们对前往发热门诊就诊的非COVID-19住院患者的最终诊断进行了探索性调查。方法 这是一项在日本东京国立全球健康与医学中心(NCGM)进行的回顾性、观察性单中心研究。我们对2020年3月11日至2020年4月24日期间在NCGM发热门诊就诊的患者进行了回顾性病历审查。患者 符合以下临床标准的患者前往NCGM发热门诊就诊:(1)体温>37.5°C,(2)任何与COVID-19一致的症状或(3)来自当地医疗机构的转诊。在发热门诊,所有符合上述标准的患者均用鼻咽拭子标本进行严重急性呼吸综合征冠状病毒2聚合酶链反应检测。症状严重或病情不稳定的患者被送往传染病门诊进行进一步评估和治疗。结果 在1470名前往发热门诊就诊的患者中,84名患者住院,其中45名被诊断为COVID-19。在其余39名非COVID-19患者中,有9名患有危及生命的疾病。危及生命的疾病包括急性心力衰竭、感染性休克、肺孢子菌肺炎、扁桃体周围脓肿和坏死性筋膜炎。结论 即使在COVID-19大流行时代,医生在考虑其他危及生命的情况时也应仔细评估每一位患者。