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Covid-19 患者回顾性研究:孟加拉国杰索尔二级保健医院的真实临床经验。

A Retrospective Study of Covid-19 Patients: A Real-Life Experience in a Secondary Care Hospital, Jashore, Bangladesh.

机构信息

Dr Goutam Kumar Acherjya, Associate Professor (CC) (Medicine), Jashore Medical College (JMC), Jashore, Bangladesh; E-mail:

出版信息

Mymensingh Med J. 2024 Apr;33(2):544-553.

Abstract

Covid-19 was first detected on 8th March of 2020 in Bangladesh after the global pandemic being started. As a new virus and disease there are scarcity of data of SARS-CoV-2 and Covid-19 respectively in our country. Aim of this study is to assess the demographic characteristics, clinical profiles, underlying co-morbid conditions, treatment pattern and outcome of the SARS-CoV-2 positive patients in Jashore, Bangladesh. This retrospective study recruited 208 RT-PCR positive Covid-19 patients from 1st April 2020 to 15th May 2020 who appeared at Flu corner centre, 250 Bedded General Hospital, Jashore, Bangladesh. Data was collected online through telephone, mobile and email due to the high contagious property of Covid-19. Out of total 208 Covid-19 patients, the mean age of the participants was 37.0±15.0 years with a male and female ratio of 2.06:1. Underlying comorbidities were documented in 36.5% of total Covid-19 patents of which hypertension in 16.3%, diabetes in 14.4%, respiratory diseases in 8.7% and pre-existing coronary arterial diseases in 6.3% patients. Though 17.8% Covid-19 patients were asymptomatic, the most common symptoms were fever (68.8%), cough (30.8%), myalgia (30.8%), sore throat (22.1%), vertigo (21.6%), respiratory distress (20.7%), anorexia (17.8%), nasal congestion (16.3%), nausea or vomiting (13.9%) and diarrhoea (13.0%). Whereas, the symptomatic patients were classified as flu-like illness (77.9%), mild to moderate pneumonia (2.4%) and severe pneumonia (1.9%). Many patients (19.2%) recovered spontaneously and 22.1% patients cured by the only simple symptomatic treatment. The most commonly received antibiotics were Azithromycin and Doxycycline. Home stay management was demonstrated in 73.1% patients, whereas, 26.0% patients required general ward admission and only 0.9% patients required referral for the HDU or ICU management with an average duration of hospital stay of 16±6 days. A high satisfactory outcome was found as evident by complete recovery in 98.08% of Covid-19 patients, complications (0.48%) and fatality (1.44%) even in this secondary care center. Therefore, we can conclude that the disease was well managed with highly satisfactory outcomes even in the low resource health care setting in the early stage of Covid-19 pandemic era. Hence, the early case detection, identification of the high-risk groups and proper management may mitigate to develop complications and fatalities of Covid-19.

摘要

2020 年 3 月 8 日,全球大流行开始后,孟加拉国首次发现了新冠病毒。由于 SARS-CoV-2 和新冠病毒分别是一种新病毒和新疾病,因此我国对它们的相关数据知之甚少。本研究旨在评估孟加拉国杰索尔的 SARS-CoV-2 阳性患者的人口统计学特征、临床特征、潜在合并症、治疗模式和结局。这项回顾性研究于 2020 年 4 月 1 日至 5 月 15 日期间从孟加拉国杰索尔的 250 张病床综合医院的 Flu corner 中心招募了 208 名 RT-PCR 阳性的新冠病毒患者。由于新冠病毒具有高度传染性,因此通过电话、手机和电子邮件在线收集数据。在总共 208 名新冠病毒患者中,参与者的平均年龄为 37.0±15.0 岁,男女比例为 2.06:1。在所有新冠病毒患者中,有 36.5%的患者存在潜在合并症,其中高血压占 16.3%,糖尿病占 14.4%,呼吸系统疾病占 8.7%,既往存在冠状动脉疾病占 6.3%。尽管 17.8%的新冠病毒患者无症状,但最常见的症状是发烧(68.8%)、咳嗽(30.8%)、肌肉疼痛(30.8%)、喉咙痛(22.1%)、眩晕(21.6%)、呼吸窘迫(20.7%)、食欲不振(17.8%)、鼻塞(16.3%)、恶心或呕吐(13.9%)和腹泻(13.0%)。而有症状的患者被分为流感样疾病(77.9%)、轻度至中度肺炎(2.4%)和严重肺炎(1.9%)。许多患者(19.2%)自然康复,22.1%的患者仅通过简单的对症治疗治愈。最常使用的抗生素是阿奇霉素和强力霉素。73.1%的患者接受了居家管理,26.0%的患者需要普通病房入院,只有 0.9%的患者需要转诊到 HDU 或 ICU 进行治疗,平均住院时间为 16±6 天。由于 98.08%的新冠病毒患者完全康复,仅有 0.48%的患者出现并发症,1.44%的患者死亡,因此可以认为治疗效果非常满意,即使在这个二级保健中心也是如此。因此,我们可以得出结论,即使在新冠病毒大流行早期的资源有限的医疗保健环境中,该疾病也得到了很好的管理,治疗效果非常满意。因此,早期发现病例、识别高危人群和进行适当管理,可能有助于减少新冠病毒并发症和死亡的发生。

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