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四川省 2019 年冠状病毒病(COVID-19)住院患者的临床特征。

Clinical characteristics of inpatients with coronavirus disease 2019 (COVID-19) in Sichuan province.

机构信息

Chinese Evidence-based Medicine Center and Cochrane China Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.

Department of Clinical Research Management, West China Hospital, Sichuan University, Chengdu, 610041, China.

出版信息

BMC Infect Dis. 2021 Feb 8;21(1):155. doi: 10.1186/s12879-021-05825-1.

Abstract

BACKGROUND

The outbreak of COVID-19 has resulted in serious concerns in China and abroad. To investigate clinical features of confirmed and suspected patients with COVID-19 in west China, and to examine differences between severe versus non-severe patients.

METHODS

Patients admitted for COVID-19 between January 21 and February 11 from fifteen hospitals in Sichuan Province, China were included. Experienced clinicians trained with methods abstracted data from medical records using pre-defined, pilot-tested forms. Clinical characteristics between severe and non-severe patients were compared.

RESULTS

Of the 169 patients included, 147 were laboratory-confirmed, 22 were suspected. For confirmed cases, the most common symptoms from onset to admission were cough (70·7%), fever (70·5%) and sputum (33·3%), and the most common chest CT patterns were patchy or stripes shadowing (78·0%); throughout the course of disease, 19·0% had no fever, and 12·4% had no radiologic abnormality; twelve (8·2%) received mechanical ventilation, four (2·7%) were transferred to ICU, and no death occurred. Compared to non-severe cases, severe ones were more likely to have underlying comorbidities (62·5% vs 26·2%, P = 0·001), to present with cough (92·0% vs 66·4%, P = 0·02), sputum (60·0% vs 27·9%, P = 0·004) and shortness of breath (40·0% vs 8·2%, P <  0·0001), and to have more frequent lymphopenia (79·2% vs 43·7%, P = 0·003) and eosinopenia (84·2% vs 57·0%, P = 0·046).

CONCLUSIONS

The symptoms of patients in west China were relatively mild, and an appreciable proportion of infected cases had no fever, warranting special attention.

摘要

背景

COVID-19 的爆发引起了国内外的严重关注。为了调查中国西部确诊和疑似 COVID-19 患者的临床特征,并研究重症与非重症患者之间的差异。

方法

纳入 2020 年 1 月 21 日至 2 月 11 日期间四川省 15 家医院收治的 COVID-19 患者。经验丰富的临床医生使用预定义的、经过试点测试的表格,根据培训方法从病历中提取数据。比较重症与非重症患者的临床特征。

结果

169 例患者中,147 例为实验室确诊,22 例为疑似。确诊病例从发病到入院最常见的症状为咳嗽(70.7%)、发热(70.5%)和咳痰(33.3%),最常见的胸部 CT 表现为斑片状或条纹状阴影(78.0%);整个病程中,19.0%的患者无发热,12.4%的患者无影像学异常;12 例(8.2%)接受机械通气,4 例(2.7%)转至 ICU,无死亡病例。与非重症病例相比,重症病例更有可能合并基础疾病(62.5% vs. 26.2%,P=0.001),更有可能出现咳嗽(92.0% vs. 66.4%,P=0.02)、咳痰(60.0% vs. 27.9%,P=0.004)和呼吸急促(40.0% vs. 8.2%,P<0.0001),且更常见淋巴细胞减少(79.2% vs. 43.7%,P=0.003)和嗜酸性粒细胞减少(84.2% vs. 57.0%,P=0.046)。

结论

中国西部患者的症状相对较轻,相当一部分感染病例无发热,需要特别注意。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61ec/7869486/d3c7f005e5c2/12879_2021_5825_Fig1_HTML.jpg

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