Zhang W, Xu Y, Xiang R, Gao L
Department of Otolaryngology Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China.
Department of Otolaryngology Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China; Research Institute of Otolaryngology Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2020 Nov 7;55(11):1032-1036. doi: 10.3760/cma.j.cn115330-20200411-00288.
To investigate the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) with pharyngeal symptoms. From January 10 to May 15, 2020, clinical data of 1 228 patients with COVID-19 in Renmin Hospital of Wuhan University was collected (554 males and 674 females, with the range of age from 10 to 95 years old, the average age was 55.2 years old). The patients were divided into pharyngeal symptoms group (PS, 126 cases) and non-pharyngeal symptoms group (Non-PS, 1 102 cases) according to the presence or absence of pharyngeal symptoms such as pharyngalgia, pharyngeal dryness, pharyngeal itching, and pharyngeal foreign body sensation. The clinical data in terms of age, sex, medical history, duration of symptoms, treatment time, clinical classification, pulmonary imaging findings, whole blood cell count, serum hypersensitivity C-reactive protein, C-reactive protein, procalcitonin were statistically analyzed between the two groups. Chi-square, Fisher's exact test and Mann-Whitney test were used for statistical analysis. The most common pharyngeal symptoms were pharyngalgia (59.52%, 75/126), followed by foreign body sensation (23.02%, 29/126), pharyngeal dryness (8.73%, 11/126), and itching (8.73%, 11/126). The median age of the patients in the PS group was 51.50 years old, which was less than 57.50 years old in the non-PS group, showing a significant difference (<0.05). The female cases accounted for 65.08% (82/126), which was higher than 53.72% (592/1 102) of the non-PS group (<0.05). The incidence of bilateral lung inflammation confirmed by CT images was 73.81% (93/126), which was significantly lower than 83.48% (920/1 102) in the non-PS group (<0.05). No significant differences were shown in the proportion of patients with clinical types, treatment days, duration of symptoms, white blood cell count, lymphocyte count, lymphocyte percentage, eosinophil count, eosinophil percentage, hypersensitive C-reactive protein, C-reactive protein, D-dimer, procalcitonin and other indicators (>0.05). The incidence of pharyngeal symptoms in patients with COVID-19 is 10.26%. Most of these symptoms occur before or at the same time as the common symptoms of the disease. Therefore, patients with such symptoms may bring a greater risk of infection to otolaryngologist. According to the current clinical classification criteria, pharyngeal symptoms have no obvious correlation with the degree of the disease; but the presence of pharyngeal symptoms may suggest a milder clinical presentation and a better prognosis.
探讨新型冠状病毒肺炎（COVID-19）伴咽部症状患者的临床特征。收集2020年1月10日至5月15日武汉大学人民医院1228例COVID-19患者的临床资料（男性554例，女性674例，年龄10～95岁，平均年龄55.2岁）。根据是否存在咽痛、咽干、咽痒、咽异物感等咽部症状，将患者分为咽部症状组（PS组，126例）和无咽部症状组（非PS组，1102例）。对两组患者的年龄、性别、病史、症状持续时间、治疗时间、临床分型、肺部影像学表现、全血细胞计数、血清超敏C反应蛋白、C反应蛋白、降钙素原等临床资料进行统计学分析。采用卡方检验、Fisher确切概率法和Mann-Whitney检验进行统计学分析。最常见的咽部症状为咽痛（59.52%，75/126），其次为异物感（23.02%，29/126）、咽干（8.73%，11/126）和咽痒（8.73%，11/126）。PS组患者的中位年龄为51.50岁，低于非PS组的57.50岁，差异有统计学意义（<0.05）。女性病例占65.08%（82/126），高于非PS组的53.72%（592/1102），差异有统计学意义（<0.05）。CT图像证实的双侧肺炎发生率为73.81%（93/126），显著低于非PS组的83.48%（920/1102），差异有统计学意义（<0.05）。临床类型、治疗天数、症状持续时间、白细胞计数、淋巴细胞计数、淋巴细胞百分比、嗜酸性粒细胞计数、嗜酸性粒细胞百分比、超敏C反应蛋白、C反应蛋白、D-二聚体、降钙素原等指标的患者比例差异无统计学意义（>0.05）。COVID-19患者咽部症状的发生率为10.26%。这些症状大多在疾病常见症状之前或同时出现。因此，有此类症状的患者可能给耳鼻喉科医生带来更大的感染风险。根据目前的临床分类标准，咽部症状与疾病严重程度无明显相关性；但咽部症状的存在可能提示临床表现较轻、预后较好。
