安徽省阜阳市新型冠状病毒肺炎普通型及重型病例临床特征分析

目的分析普通型及重型新型冠状病毒肺炎病例的临床特征,探讨重型/危重型病例相关危险因素。方法回顾性分析阜阳市第二人民医院2020年1月20日—2月10日期间住院治疗的125例新型冠状病毒肺炎确诊病例的临床特点,比较疾病不同分型患者的相关临床指标。结果125例中发热116例,平均最高体温为(38.38±0.62)℃,肺部干湿性啰音12例;发病到就诊时间(5.90±3.32)d;影像学示双侧多发病变103例,淡片状或片絮状阴影87例,48 h进展迅速者25例;血白细胞总数(5.12±1.95)×10^9/L,淋巴细胞计数(1.33±0.66)×10^9/L,C反应蛋白(28.00±36.28)mg/L,降钙素原(0.09±0.32)ng/mL,血清淀粉样蛋白A(102.39±81.41)mg/L,白细胞介素-6(33.94±64.00)pg/mL。重型/危重型组与普通型组的年龄、最高体温、呼吸频率、心率、指脉氧饱和度、淋巴细胞计数、C反应蛋白、血清淀粉样蛋白A和白细胞介素-6等比较,差异均有统计学意义(P<0.05)。结论新型冠状病毒肺炎症状多而体征少为其临床特征,淋巴细胞计数多减少,影像多示双肺广泛分布浸润阴影。及早识别重型/危重型病例的预警征象,以有效减少重型/危重型病例的发生。

Clinical characteristics analysis of common and severe cases with COVID-19, Fuyang,Anhui

Objective To discuss the clinical characteristics and the risk factors related to severe/critical cases of coronavirus disease 2019 (COVID-19) patients.Methods The clinical characteristics of 125 confirmed COVID-19 cases admitted to The Second People^,s Hospital of Fuyang from January 20 to February 10, 2020 were retrospectively analyzed, and relevant clinical indicators of patients with different disease types were compared.Results Of the 125 patients, 116 cases were with fever, average maximum temperature was (38.38±0.62) ℃, 12 cases with dry and wet rales heard in the lungs. Time from onset to admission was (5.90±3.32) days. Radiologic characteristic showed that there were 103 cases of bilateral multiple lesions, 87 cases of light flake flocculent shadow, and 25 cases of rapid progress within 48 hours. The total number of leukocytes was (5.12±1.95)×10⁹/L, the number of lymphocyte was (1.33±0.66)×10⁹/L, the level of C-reactive protein was (28.00±36.28) mg/L, the level of procalcitonin was (0.09±0.32) ng/mL, the level of serum amyloid protein A was (102.39±81.41) mg/L, the level of interleukin-6 was (33.94±64.00) pg/mL. Compared with common cases, there were significant differences in age, maximum body temperature, respiratory rate, heart rate, oxygen saturation, lymphocyte count, C-reactive protein, serum amyloid protein A and interleukin-6 in the severe or critical case group (P<0.05).Conclusion The clinical features are shown with symptoms and fewer signs. The number of leukocytes is decreased, inflammatory cytokines are increased and procalcitonin stays relatively steady. Radiologic characteristic indicates that both lungs are widely distributed with infiltrating shadows. Timely identifying early warning signs in severe/critical cases and high risk group, and control gateways of the city can effectively reduce severe/critical cases and mortality rate.