Hong Jian-Ming, Hu Long-Hua, Zhong Qiao-Shi, Zhu Long-Chuan, Hang Ya-Ping, Fang Xue-Yao, Sun Hua-Bao, Huang Zhi-Hua, Xu Jianping, Chen Yan-Hui
Clinical Laboratory, The Ninth Hospital of Nanchang, Nanchang, China.
Jiangxi Provincial Key Laboratory of Medicine, Clinical Laboratory, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
Front Med (Lausanne). 2020 Nov 4;7:571069. doi: 10.3389/fmed.2020.571069. eCollection 2020.
The 2019 novel coronavirus disease (COVID-19) pandemic is the biggest public health crises in the 21st century. While most patients infected with the COVID-19 virus have no to moderate symptoms, there is currently limited clinical information about these patients. In this study, we retrospectively investigated 41 patients infected with the COVID-19 virus in Nanchang, Jiangxi province, China, from February 4 to March 2, 2020. Nanchang is about 260 km southeast of Wuhan, the initial epicenter of the COVID-19 pandemic. We retrieved information on patient demographics, physical examination results, epidemiology, clinical manifestations, underlying conditions, laboratory analyses, radiological images, and treatment outcomes. Most patients (70.7%) had a history of close contact with patients with confirmed COVID-19, and 16 patients (39.0%) showed a high degree of family clustering. All 41 patients had no to moderate symptoms. The median age was 39.9 years and common symptoms of illness were fever (69.2%), cough (65.4%), and fatigue (19.2%). The dominant patient group was middle-aged women, with hypertension (14.6%) and chronic liver disease (12.2%) as the most frequent underlying conditions. All patients recovered, with the mean time of viral nucleic acid clearance at 10.6 days. Chest CT scans presented ground-glass opacities in 53.7% of patients while 26.8% had normal CT images. Laboratory results showed that lymphocyte counts, lymphocyte percentages, ESR, CRP, IgG, Fib, and cytokines were correlated to patients' conditions. Approximately 60-90% of patients had abnormally high levels of cytokines IL-4, IL-6, IL-10, and/or TNF-α. Our results showed variable clinical and laboratory presentations among this group of patients infected with the COVID-19 virus. Though all 41 patients recovered, our results suggest that cytokine levels and other biochemical indicators should be monitored for patients infected with the COVID-19 virus showing no to moderate symptoms to ensure quick access for critical medical attention, if needed.
2019年新型冠状病毒病(COVID-19)大流行是21世纪最大的公共卫生危机。虽然大多数感染COVID-19病毒的患者症状轻微至中度,但目前关于这些患者的临床信息有限。在本研究中,我们回顾性调查了2020年2月4日至3月2日在中国江西省南昌市感染COVID-19病毒的41例患者。南昌位于COVID-19大流行最初的中心武汉东南约260公里处。我们获取了患者的人口统计学信息、体格检查结果、流行病学、临床表现、基础疾病、实验室分析、影像学图像和治疗结果。大多数患者(70.7%)有与确诊COVID-19患者密切接触史,16例患者(39.0%)表现出高度的家庭聚集性。所有41例患者症状轻微至中度。中位年龄为39.9岁,常见症状为发热(69.2%)、咳嗽(65.4%)和乏力(19.2%)。主要患者群体为中年女性,最常见的基础疾病是高血压(14.6%)和慢性肝病(12.2%)。所有患者均康复,病毒核酸清除平均时间为10.6天。胸部CT扫描显示53.7%的患者有磨玻璃影,26.8%的患者CT图像正常。实验室结果显示淋巴细胞计数、淋巴细胞百分比、血沉、C反应蛋白、免疫球蛋白G、纤维蛋白原和细胞因子与患者病情相关。约60-90%的患者细胞因子白细胞介素-4、白细胞介素-6、白细胞介素-10和/或肿瘤坏死因子-α水平异常升高。我们的结果显示,这组感染COVID-19病毒的患者临床和实验室表现各异。尽管所有41例患者均康复,但我们的结果表明,对于症状轻微至中度的COVID-19病毒感染患者,应监测细胞因子水平和其他生化指标,以确保在需要时能迅速获得关键医疗救治。