海南省新型冠状病毒肺炎流行病学特征分析

目的分析和描述截至2020年3月4日海南省报告的新型冠状病毒肺炎病例的流行病学特征。为下一阶段的防控策略和措施制定提供科学依据。方法采用描述流行病学方法进行分析:疫情的地区分布、时间分布、人群特征、聚集性疫情、病例发病就诊情况分析、本地病例和重症病例情况分析。结果共报告168例确诊病例,其中重症36例,死亡5例。病例主要分布在海口、三亚等旅游热点市县。2020年1月13日出现首例病例,1月24日达发病高峰,2月6日后发病呈下降趋势。男女性别比为0.9∶1,年龄中位数51岁,50岁以上占54.8%。离退人员占比最高,占36.9%。2月以来本地病例所占比例呈上升趋势。本地病例发病到就诊,首诊到确诊,发病到确诊和发病到入院时间中位数均大于输入病例。重/危重病例年龄中位数、患有基础疾病的病例比例均大于轻/普通型病例。重/危重症病例发病到就诊时间大于轻/普通型病例,但就诊到确诊时间前者小于后者。结论海南省疫情呈现3个阶段,从以输入性为主,发展为以本地病例发病为主,到低水平发病阶段。应加强服务行业人群个人防护、健康监测,对所有密切接触者集中隔离,加强宣传教育,提高老百姓尤其是60岁以上老人就诊意识,医疗机构应关注60岁以上有基础疾病的病例病情变化。要加大返工后的疫情监测和入境人员的健康管理,巩固防控成效。     

福建省新型冠状病毒肺炎流行病学特征分析

目的描述和分析福建省新型冠状病毒肺炎病例的流行病学特征,为防控提供依据。方法选取经中国疾病预防控制信息系统网络直报的福建省新型冠状病毒肺炎病例,回顾性描述该省疫情概况、疾病的三间分布以及聚集性疫情特征。结果截至2020年2月21日24时,累计报告病例298例,死亡1例,病死率0.3%。其中确诊病例293例(98.3%),现有疑似病例2例(0.7%),无症状感染者3例(1.0%)。确诊病例中,病情严重程度以普通型肺炎为主199例(67.9%),男女比例1.22∶1,年龄以25~54岁居多(199例,67.9%)。流行曲线表现为单峰流行,确诊病例最早发病时间为1月2日,61.8%病例集中在1月21日-30日间发病。除平潭综合实验区外,其余9个设区市均报告确诊病例,主要分布在福州(71例,24.2%)、莆田(55例,18.8%)、泉州(46例,15.7%)。27个(30.7%)县(市、区)无确诊病例报告。累计报告聚集性疫情50起,涉及病例177例。结论福建省新冠肺炎病例主要为输入性病例,输入性病例以中青年为主,而本地病例则以中老年为主,除平潭外的各地市均有确诊病例报告。输入性病例流行曲线与人员返闽等相吻合,本地病例流行较输入病例晚一周。各设区市均报告聚集性疫情,以家庭性聚集为主。     

新型冠状病毒肺炎多代聚集性病例流行特征调查

目的掌握COVID-19多代聚集性病例相关特征,对河南省报告的多代聚集性病例进行流行病学描述和分析。方法选取截至2020年2月23日突发公共卫生事件管理信息系统中河南省上报的COVID-19传播代次≥3代的聚集性疫情。分析包括:①病例的基本特征;②地区分布、时间分布、临床类型分布;③疾病的潜伏期。结果河南省内多代聚集性病例占河南省内所有确诊病例数的9.05%,且普通型(51.54%)和轻型病例(23.08%)占比较高。河南省内多代聚集性病例占其所在地确诊病例比例最高可达60.38%,报告起数最多有4起。病例代次多集中在2代(58.46%)、3代(23.85%)病例。发病至确诊时间间隔随着代次的增加逐渐下降。高年龄组(>65岁)人群危重症比例(42.86%)最高。潜伏期中位数为5 d。结论COVID-19潜伏期长,传播力强且潜伏期具有传染性,因此聚集性疫情是防控的关键。对多代聚集性病例的分析和了解,可以在一定程度上,对即将复工复学形成的人员聚集的动态防控提供一定的指导作用。     

北京65例新型冠状病毒肺炎患者临床特征分析

目的分析新型冠状病毒肺炎(COVID-19)确诊病例的流行病学、临床症状及实验室检查指标,为全面总结COVID-19的临床特征与正确评价患者预后提供依据。方法采用回顾性研究方法,以2020年1月20日—2月29日期间本中心收治的65例COVID-19患者为研究对象,根据临床症状将患者分为轻型组(18例),普通型组(31例)和重/危重型组(16例)3组,对所有患者流行病学、临床症状及实验室检查指标进行分析。结果 65例COVID-19患者中男37例(57%),女28例(43%);年龄3～85岁,平均(46.63±18.63)岁。从出现症状到入院平均时长为(7.00±5.02)d,住院时间为(17.07±10.51)d。3组间及两两分组之间年龄比较差异均具有统计学意义(P均0.05),即年龄越大的患者病情越重。相较于轻型组和普通型组患者,重/危重型组患者合并有更多的基础疾病。COVID-19患者临床症状以发热(75%)、咳嗽(57%)、肌痛或乏力(43%)为主,其余症状还包括咳痰,头痛,胸闷、气短及腹泻等。24例(37%)有武汉暴露史,19例(29%)有家族聚集性接触史。实验室检查结果显示:3组患者WBC和淋巴细胞绝对计数降低;D-二聚体,CRP,IL-6及ESR水平升高。在重/危重型组患者中,8例(50%)出现淋巴细胞绝对计数下降,9例(9/14,64%)出现D-二聚体水平升高。此外,重/危重型组患者中,CRP、IL-6、降钙素原和ESR水平都显著升高。COVID-19患者住院时间与淋巴细胞绝对计数呈负相关。结论 COVID-19患者的临床特点复杂,一般以发热、咳嗽、肌痛或乏力为主要症状。与轻型组和普通型组患者相比,重/危重型组患者淋巴细胞绝对计数减少和炎症相关的指标上升更显著,免疫平衡失调,可能影响患者的疾病进展、恢复和预后。     

新型冠状病毒肺炎35例流行病学及临床特征分析

目的探讨聊城市2019年冠状病毒(SARS-COV-2)感染肺炎患者的流行病学特点、临床表现、实验室检查、影像学表现。方法收集2020年1月28日到2020年2月24日在山东省聊城市传染病医院收治的经SARS-CoV-2核酸检测确诊的35例2019年新型冠状病毒感染肺炎(COVID-19)患者,收集患者流行病学情况、年龄、发病时间、首发症状、血常规、淋巴细胞计数、降钙素原(PCT)、血清淀粉样蛋白A(SAA)、C反应蛋白(CRP)及胸部CT表现等信息并进行分析。结果 35例患者中11%与武汉市或湖北其他地区具有明确接触史,77%无明确暴露史;83%为聚集性发病,17%为输入性病例;中位就诊时间为5(0.00～8.00)天,43%患者具有基础疾病;71%患者初始症状为发热,60%初始症状为咳嗽,14.3%初始可无任何症状;实验室检查中94.3%的患者白细胞正常及下降,45.7%患者淋巴细胞计数可下降,74.3%和45.7%患者SAA和CRP可升高,14.3%患者PCT正常;91.4%患者初次核酸检测为阳性,91.4%患者胸部CT表现为单肺或双肺多发磨玻璃样病灶;入组患者91.4%为普通型,治疗上均给予给予α-干扰素雾化吸入联合洛匹那韦及利托那韦治疗,71.4%给予了抗菌药物治疗,14.3%使用激素进行治疗;所有患者病情好转,22例患者治愈出院。结论 SARS-COV-2具有传染性强,家庭聚集性感染可能是本市的主要播散方式,普通型多见,实验室检查无特异性改变,治疗后均病情稳定。     

某养老机构新型冠状病毒肺炎聚集性疫情流行病学特征分析

目的对某养老机构发生一起新型冠状病毒肺炎(COVID-19)聚集性疫情进行回顾性流行病学调查和分析。方法采用"新型冠状病毒肺炎防控方案(第三版)"推荐的个案调查表和依照"新型冠状病毒肺炎聚集性疫情流行病学调查指南(试行第一版)"进行。结果某养老机构有8名护理人员和住院老人感染新冠肺炎,年龄中位为59岁,男、女比例1∶7。于末次暴露后4~15 d确诊。排查出225名密切接触者,无三代院内续发传播;不排除无症状感染存在传染的可能性;病亡1例。结论本次聚集性疫情的感染来源于新冠肺炎确诊病例。建议防控策略应关注养老机构、监管场所等重点部门、重点人群的管控与监测。     

武汉地区52例普通型和重型新型冠状病毒肺炎患者临床特征分析

目的：总结武汉地区52例普通型和重型新型冠状病毒肺炎（COVID-19）患者的临床特征,以提高对该病的认识。方法：收集COVID-19普通型25例和重型27例患者的临床资料,对比分析2组患者的临床症状及实验室检查结果,将2组具有差异的指标绘制受试者工作特征(ROC)曲线,找出最佳截断值。结果：重型组年龄大于普通型组。主要临床表现有发热、乏力、食欲差、咳嗽、咳痰、喘息气短、腹泻等,其中重型组患者乏力、食欲差表现较普通型更为明显。实验室检查发现27%的患者出现淋巴细胞计数减少,其中重型组淋巴细胞减少例数较普通型患者更多,重型组患者中性粒细胞/淋巴细胞比值（NLR）高于普通型;重型组患者血C反应蛋白（CRP）水平高于普通型;52例患者中,天门冬氨酸转氨酶（AST）、肌酸激酶（CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)升高患者分别占25.0%、13.5%、13.5%、48.1%,其中重型组患者AST、CK-MB及LDH值高于普通型;ROC曲线结果显示NLR、CRP、AST、LDH预测COVID-19重型患者的曲线下面积均＞0.7,有一定的预测价值。结论：预估COVID-19患者病情时,需结合病史、临床症状、实验室检查等综合评估, NLR、CRP、AST、LDH对COVID-19重型患者有一定的预测价值。     

Differences in clinical characteristics and liver injury between suspected and confirmed COVID-19 patients in Jingzhou,Hubei Province of China

To evaluate the clinical characteristics and liver injury in coronavirus disease 2019 (COVID-19) patients, and analyze the differences between suspected and confirmed COVID-19 patients, this retrospective study was performed on 157 COVID-19 patients and 93 suspected patients who were ultimately excluded from COVID-19 (control patients). Differences in clinical characteristics and liver injury between suspected and confirmed COVID-19 patients were analyzed. Age, male sex, fever, chest tightness and dyspnea were related to the severity of COVID-19. C-reactive protein (CRP) and D-dimer may be predictors of the severity of COVID-19. Computed tomography (CT) played an important role in the screening of COVID-19 and the evaluation of disease severity. Multiple factors may cause liver injury in COVID-19 patients. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may be more likely to cause liver injury than common respiratory infectious diseases. Age, temperature (T), white blood cell (WBC), lymphocytes (LY), hematocrit (HCT), CRP, and finger pulse oxygen saturation (SpO₂₎ may correlate with liver function impairment and may predict the occurrence and severity of liver function impairment. Some therapeutic drugs (like glucocorticoid) may be involved in the liver function impairment of COVID-19 patients. Most liver function indices improved significantly after active treatment. Although COVID-19 and other common respiratory infectious diseases share some clinical characteristics, COVID-19 has its own characteristics.     

蚌埠地区79例新型冠状病毒肺炎患者临床特征

目的 提高对新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)患者临床特征及早期转归的认识.方法 回顾性分析2020年1月25日—3月4日蚌埠医学院第一附属医院收治经新型冠状病毒核酸检测确诊的79例资料完整的COVID-19出院患者病例资料及出院后3个月43例患者的随访资料.结果 7...     

安庆市新型冠状病毒肺炎疫情暴发前后流行性感冒流行特征分析

[摘要]　目的　分析新型冠状病毒肺炎疫情（新冠疫情）暴发前、后2个年度,安庆市流行性感冒（流感）流行的强度和特征。方法　在“中国流感监测信息系统”中选取安庆市2019—2021年度监测数据,分析我市新冠疫情发生前、后的流感样病例就诊百分比、病原学阳性率和聚集性疫情的变化。结果　新冠疫情前、后2个年度,流感样病例就诊百分比分别为4.17%和3.78%,差异有统计学意义（χ2=56.652,P=0.000）;病原学阳性率分别为23.43%和1.15%,差异有统计学意义（χ2=538.694,P=0.000）。新冠疫情前的流感病毒活动呈现双峰分布,新冠疫情后全年仅检出27份流感病毒阳性样本。结论　新冠疫情中采取的严格非药物预防措施,对流感的季节性特征有重要影响。应通过疫苗接种和非药物预防等措施,做好流感防控工作。     

Epidemiology of COVID-19 in Jiangxi,China: A retrospective observational study

To analyze the epidemiological characteristics of coronavirus disease 2019 (COVID-19) in Jiangxi Province, China, from January 21 to April 9, 2020.COVID-19 epidemic information was obtained from the official websites of the Jiangxi Provincial Health Committee, Hubei Provincial Health Committee, and National Health Commission of the People''s Republic of China. ArcGIS 10.0 was used to draw a map of the spatial distribution of the cases.On January 21, 2020, the first COVID-19 confirmed case in Jiangxi was reported. By January 27, COVID-19 had spread rapidly to all cities in Jiangxi. The outbreak peaked on February 3, with a daily incidence of 85 cases. The last indigenous case reported on February 27. From January 21 to April 9, a total of 937 confirmed cases of COVID-19 were reported, with a cumulative incidence of 2.02/100,000. Of those, 936 patients (99.89%) were cured, and 1 (0.11%) died due to COVID-19. The COVID-19 epidemic trend in Jiangxi was basically consistent with the national epidemic trend (except Hubei). Throughout the epidemic prevention and control phase, Jiangxi province has taken targeted prevention and control measures based on the severity of the spread of COVID-19.The COVID-19 epidemic in Jiangxi was widespread and developed rapidly. In less than 1 month, the epidemic situation was effectively controlled, and the epidemic situation shifted to a low-level distribution state. All these proved that the COVID-19 prevention and control strategies and measures adopted by Jiangxi Province were right, positive and effective.     

Gastrointestinal symptoms in patients hospitalized with COVID-19: Prevalence and outcomes

To characterize outcomes in patients hospitalized with coronavirus disease 2019 (COVID-19) who present with gastrointestinal (GI) symptoms.Clinical outcomes in patients with COVID-19 associated with GI symptoms have been inconsistent in the literature.The study design is a retrospective analysis of patients, age 18 years or older, admitted to the hospital after testing positive for COVID-19. Clinical outcomes included intensive care unit requirements, rates of discharges to home, rates of discharges to outside facilities, and mortality.Seven hundred fifty patients met the inclusion criteria. Three hundred seventy three (49.7%) patients presented with at least one GI symptom and 377 (50.3%) patients presented with solely non-GI symptoms. Patients who presented with at least one GI symptom had significantly lower ICU requirements (17.4% vs 20.2%), higher rates of discharges home (77.2% vs 67.4%), lower rates of discharges to other facilities (16.4% vs 22.8%), and decreased mortality (6.4% vs 9.8%) compared with patients with non-GI symptoms. However, patients who presented with solely GI symptoms had significantly higher ICU requirements (23.8% vs 17.0%), lower rates of discharges home (52.4% vs 78.7%), higher rates of discharges to facilities (28.6% vs 15.6%), and higher mortality (19.0% vs 5.7%) compared with those with mixed GI and non-GI symptoms.Although patients with COVID-19 requiring hospitalization with GI symptoms did better than those without GI symptoms, those with isolated GI symptoms without extra-GI symptoms had worse clinical outcomes. COVID-19 should be considered in patients who present with new onset or worsening diarrhea, nausea, vomiting, and abdominal pain even without pulmonary symptoms.