26例新型冠状病毒肺炎病例临床特征分析

目的分析新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)患者的流行病学特点、临床表现、实验室检查及影像学特征。方法收集26例COVID-19患者的流行病学资料和临床资料,采用SPSS 19.0软件进行统计分析。结果 11例(42.3%)患者有武汉旅居史,6例(23.1%)患者与武汉旅居人员有接触史,6例患者呈家族聚集性发病;中位潜伏期6 d。26例患者中普通型18例(69.2%),重型6例(23.1%),轻型2例(7.7%)。重型患者较普通型出现乏力和胸闷人数更多(均有P<0.05),而两组患者发热、干咳、肌肉酸痛、纳差、咽痛、腹痛表现无差异(均有P>0.05)。将普通型和重型患者实验室指标进行比较,重型患者淋巴细胞(lymphocyte,Lym)计数、嗜酸性粒细胞(eosinophil,Eos)计数和CD3^+、CD4^+、CD8^+T细胞计数均低于普通型(均有P<0.05)。C-反应蛋白(C-reactive protein,CRP)和血清淀粉样蛋白A(serum amyloid A,SAA)重型组高于普通型(均有P<0.05)。23例(88.5%)患者肺部CT出现磨玻璃样改变,15例(57.7%)出现小叶间隔增厚,10例(38.5%)患者出现马赛克征,5例(19.2%)患者肺部有纤维化病灶。结论本组COVID-19患者多为武汉旅居人员或接触武汉旅居患者发病,影像学主要表现为肺部磨玻璃样病变。普通型病例多见,患者外周血Lym计数、Eos计数和CD3^+、CD4^+、CD8^+ T细胞减少、CRP和SAA升高预示病情加重。

Analysis of clinical characteristics of coronavirus disease 2019 in 26 cases

  Objective   To analyze the epidemiological characteristics, clinical manifestations, laboratory examinations and imaging characteristics of coronavirus disease 2019(COVID-19).   Methods   The data of epidemiological characteristics and clinical data were collected for data analysis. SPSS 19.0 software was used for statistical analysis.   Results   11 patients(42.3%) had a history of staying in Wuhan, 6 patients(23.1%) had a history of contact with Wuhan residents, and 6 patients had a familial cluster onset; the median incubation period was 6 d. Among the 26 patients, as for the condition, 18 cases were common(69.2%), 6 cases were severe(23.1%), and 2 cases were light(7.7%). More severe patients had higher frequency of fatigue and chest tightness than the common type(all P < 0.05), but there was no significant difference in the incidence of fever, dry cough, muscle soreness, anorexia, sore throat, and abdominal pain between the two groups(allP > 0.05). Comparing the laboratory indicators of common and severe patients, lymphocyte(Lym) count, eosinophil(Eos) count, and CD3+, CD4+, and CD8+ T cell counts of the severe patients were lower than those of the common patients(all P < 0.05). The C-reactive protein(CRP) and serum amyloid A(SAA) severe groups were higher than the common type(allP < 0.05). Ground-glass opacities were seen in the CT of the lungs in 23(88.5%) patients, lobular septal thickening in 15(57.7%), mosaic signs in 10(38.5%) patients, and fibrotic lesions in the lungs in 5(19.2%) patients.   Conclusions   Most of the COVID-19 patients in this study had a connection with Wuhan. The imaging findings were mainly ground-glass opacities. The majority were common cases. Patients with decreased peripheral blood Lym counts, Eos counts, and CD3+, CD4+, and CD8+ T cells, and elevated CRP and SAA are predictive of exacerbations.