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中国温州输入和本地新冠肺炎病例的临床特征和病毒 RNA 脱落情况。

Clinical features and viral RNA shedding of imported and local cases with COVID-19 in Wenzhou, China.

机构信息

Department of Infectious Diseases.

Infectious Diseases Laboratory, Wenzhou Sixth People's Hospital, Wenzhou Central Hospital Medical Group, Affiliated Dingli Clinical Institute of Wenzhou Medical University, Wenzhou.

出版信息

Medicine (Baltimore). 2021 Mar 19;100(11):e24826. doi: 10.1097/MD.0000000000024826.

Abstract

Wenzhou had the highest number of confirmed novel coronavirus 2019 (COVID-19) cases outside the Hubei province. The aim of this study was to identify the difference in clinical features and viral RNA shedding between the imported and local COVID-19 cases in Wenzhou.All patients with confirmed COVID-19 admitted to Wenzhou Sixth People's Hospital, Wenzhou Central Hospital Medical Group, from January 17 to February 11, 2020, were enrolled in this study. Data was analyzed and compared for the imported and local cases with regard to epidemiological, demographic, clinical, radiological features, and laboratory findings. Outcomes for the enrolled participants were followed up until May 7, 2020.Of the 136 cases, 50 were imported from Wuhan. The median age was 45 years and 73 (53.7%) were men. The most common symptoms at onset were fever (104 [76.5%]) and cough (85[62.5%]). Pleural effusion was more common among imported cases compared to local cases. The white blood cell count, neutrophil count, lymphocyte count and platelet count of the imported cases were significantly lower than those of the local cases, while the prothrombin time was significantly longer than that of the local cases. Severe and critically ill patients accounted for 15.4% and 2.9%, respectively. The median duration of SARS-CoV-2 RNA shedding from symptom onset was 26 days (IQR 17-32.3 days) and there were no significant differences in duration of viral RNA shedding between the two groups.The study findings suggest that imported cases from Wuhan were more likely to be severe compared to the local cases in Wenzhou. However, there was no difference between imported and local cases on the viral shedding among the COVID patients.

摘要

温州是湖北省外报告新冠肺炎确诊病例最多的地区。本研究旨在分析温州地区输入性和本地新冠肺炎患者的临床特征和病毒 RNA 脱落的差异。

所有 2020 年 1 月 17 日至 2 月 11 日期间因确诊新冠肺炎而被温州第六人民医院和温州中心医院医疗集团收治的患者均纳入本研究。分析并比较了输入性和本地病例的流行病学、人口统计学、临床、影像学特征和实验室检查结果。对纳入的研究对象进行了随访,直至 2020 年 5 月 7 日。

在 136 例患者中,50 例为武汉输入性病例。中位年龄为 45 岁,73 例(53.7%)为男性。发病时最常见的症状是发热(104 例[76.5%])和咳嗽(85 例[62.5%])。与本地病例相比,输入性病例更常见胸腔积液。输入性病例的白细胞计数、中性粒细胞计数、淋巴细胞计数和血小板计数明显低于本地病例,而凝血酶原时间明显长于本地病例。重症和危重症患者分别占 15.4%和 2.9%。从症状出现到 SARS-CoV-2 RNA 脱落的中位时间为 26 天(IQR 17-32.3 天),两组患者病毒 RNA 脱落时间无显著差异。

研究结果表明,与温州本地病例相比,来自武汉的输入性病例更易发展为重症。然而,输入性和本地新冠肺炎患者的病毒脱落时间并无差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce4e/7982230/55523f1ca96f/medi-100-e24826-g001.jpg

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