Li BinBin, Bao ChunMiao
Department of Respiratory Medicine, YongJia County People's Hospital, Wenzhou, China.
Department of Respiratory Medicine, The Affiliated Yangming Hospital of Ningbo University, Yuyao People's Hospital of Zhejiang Province, Yuyao, China.
Open Med (Wars). 2021 Mar 30;16(1):494-497. doi: 10.1515/med-2021-0262. eCollection 2021.
A cluster outbreak of patients with similar symptoms and computed tomographic (CT) images of COVID-19 were diagnosed with leptospirosis. This study was aimed to identify the clinical difference between leptospirosis and COVID-19, providing evidence for strategy optimization.
A cohort of leptospirosis patients were collected and compared with age- and gender-matched COVID-19 cases in the epidemiological investigation, chest CT scan, laboratory tests, and length of hospital stay.
Compared with COVID-19, contacting floodwater and lack of family clustering were features of leptospirosis in epidemiological assessment. In the laboratory test, higher level of white blood cells (WBCs: (10.38 ± 4.56) × 109/L vs (6.45 ± 1.95) × 109/L, < 0.001), C-reactive protein (CRP: (138.93 ± 73.03) mg/L vs (40.28 ± 30.38) mg/L, < 0.001), Creatine ((88.27 ± 35.16) mmol/L vs (63.31 ± 14.50) mmol/L, < 0.001), and a lower level of platelet ((152.93 ± 51.93) × 109/L vs (229.65 ± 66.59) × 109/L, < 0.001) were detected on patients with leptospirosis.
Given the epidemiological differences and seasonal prevalence, it is important to suspect leptospirosis in cases with a similar presentation of COVID-19. The clinical disparities may facilitate the therapeutic management of these two diseases.
一群出现类似症状且计算机断层扫描(CT)图像表现为新型冠状病毒肺炎(COVID-19)的患者被诊断为钩端螺旋体病。本研究旨在确定钩端螺旋体病与COVID-19之间的临床差异,为优化策略提供依据。
收集一组钩端螺旋体病患者,并在流行病学调查、胸部CT扫描、实验室检查及住院时间方面与年龄和性别匹配的COVID-19病例进行比较。
在流行病学评估中,与COVID-19相比,接触洪水和缺乏家庭聚集性是钩端螺旋体病的特征。实验室检查显示,钩端螺旋体病患者白细胞水平较高(白细胞:(10.38 ± 4.56) × 10⁹/L 对比 (6.45 ± 1.95) × 10⁹/L,P < 0.001)、C反应蛋白水平较高(C反应蛋白:(138.93 ± 73.03) mg/L 对比 (40.28 ± 30.38) mg/L,P < 0.001)、肌酐水平较高((88.27 ± 35.16) mmol/L 对比 (63.31 ± 14.50) mmol/L,P < 0.001),而血小板水平较低((152.93 ± 51.93) × 10⁹/L 对比 (229.65 ± 66.59) × 10⁹/L, P < 0.001)。
鉴于流行病学差异和季节性流行情况,对于表现类似COVID-19的病例怀疑钩端螺旋体病很重要。临床差异可能有助于这两种疾病的治疗管理。