老年慢性肾脏病3~5期非透析患者心脏瓣膜钙化特点及其与血清骨代谢标志物的相关性

目的 探讨并分析南通地区新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)聚集性患者的临床特点。 方法 采用回顾性单中心研究方法,收集2020年1月27日至2月17日南通市第三人民医院隔离病房收治的15例COVID-19聚集性患者的一般资料,按照聚集性疫情调查分析,分为五组,分别对其流行病学特征、临床表现、实验室检查和影像学特点进行分析。结果 15例患者中,男7例,女8例。年龄范围为27～67岁,五组患者平均年龄为(47.33±14.38)、(51.50±5.50)、(65.00±1.00)、(52.00±1.79)、(57.33±12.28)岁。潜伏期平均为(3.00±1.41)、(5.50±0.50)、(5.00±0.00)、(9.20±4.26)、(8.67±4.11)d。轻型患者1例(6.7%),普通型13例(86.7%),重型1例(6.7%)。五组患者中临床表现以发热为主的患者13例(86.7%),乏力14例(93.3%),咳嗽9例(58.7%),呼吸困难6例(40%),无头痛咽喉痛及消化道症状病例,基础疾病以高血压为主,并发症以肝损害为主,1例(6.7%)无任何临床表现。五组患者均有不同程度淋巴细胞计数,CD4+T淋巴细胞计数,CD8+T淋巴细胞计数及B淋巴细胞计数下降,其中三组平均淋巴细胞计数下降明显。感染指标如CRP、ESR、铁蛋白普遍升高,PCT均表现为正常。肝功能除AST轻度升高外,余均正常。乳酸水平均高。氧合指数有一组(20%)患者明显降低。影像学改变主要为双侧病变,无胸腔积液。结论 南通市新型冠状病毒肺炎聚集性病例以家庭聚集性病例为主,倾向于中老年人,常与慢性病高血压共存,肝损害为主要并发症,基本为普通型。临床表现主要为发热、乏力、咳嗽。实验室检查血乳酸水平均高,T淋巴细胞计数下降明显,余无特异性改变。     

四川省广安市17例COVID-19患者临床表现与实验室检查结果分析

目的分析四川省广安市新型冠状病毒肺炎(COVID-19)确诊患者的临床表现与实验室检查结果,以提高该市对COVID-19的诊治水平。方法收集该院17例COVID-19确诊患者资料,回顾性分析其流行病学史、临床表现、实验室和影像学检查结果,以及治疗转归。结果17例确诊患者中男8例,女9例;平均年龄(45.8±13.8)岁;普通型10例,重型3例,危重型4例。13例患者有明确的流行病学史,其中7例由武汉返乡,6例有确诊患者接触史。14例(82.4%)患者出现发热症状,其他主要症状包括咳嗽(76.5%)、呼吸困难(47.1%)、畏寒(29.4%)等。16例(94.1%)患者白细胞计数正常,11例(64.7%)患者淋巴细胞计数降低;CT表现多为单侧或双侧的磨玻璃影。17例患者均采用干扰素治疗,其中16例患者采用了中药治疗,4例危重型患者使用了糖皮质激素。患者平均住院天数为(23.8±8.9)d,病毒核酸平均转阴天数为(20.1±10.1)d。17例患者均好转出院。结论该市COVID-19患者多为输入性病例,临床分型以普通型为主;发热、咳嗽、淋巴细胞计数降低、CT表现为磨玻璃影是该病的主要临床特点。     

新型冠状病毒肺炎患者IgM抗体与血细胞计数及C反应蛋白的相关性研究

目的 探讨白细胞计数、C反应蛋白及新型冠状病毒(SARS-CoV-2)特异性IgM抗体在新型冠状病毒感染的肺炎(COVID-19)患者临床诊断中的应用价值。方法 对59例COVID-19确诊患者疾病早期的外周血白细胞、淋巴细胞及C反应蛋白进行检测分析,并采用胶体金免疫层析技术检测不同病程患者血清中SARS-CoV-2特异性IgM抗体的水平。结果①59例确诊患者中,白细胞计数正常或降低者为57例(96.61%),淋巴细胞计数降低为20例(33.9%),C反应蛋白升高者为41例(69.49%)。COVID-19患者与健康人群相比,外周血白细胞、淋巴细胞及C反应蛋白的差异有统计学意义(P 0.05);②59例确诊患者中,52例(88.14%)患者血清SARS-CoV-2特异性IgM抗体检测为阳性,健康体检者IgM抗体均为阴性。COVID-19患者在病程第(0～6)d、(7～10)d、(11～15)d、(16～20)d血清SARS-CoV-2特异性IgM抗体阳性率分别为25%、81.82%、90%、100%。③IgM阳性组与IgM阴性组比较,外周血白细胞、淋巴细胞及C反应蛋白水平的差异均无统计学意义(P0.05)。结论 ①机体感染SARS-CoV-2后,外周血白细胞计数一般正常或减低,部分患者出现淋巴细胞减少,常伴有C反应蛋白升高。动态观察白细胞、淋巴细胞和C反应蛋白的变化,对于COVID-19的临床诊断和病情观察具有重要意义。②胶体金免疫层析技术检测患者血清中的SARS-CoV-2特异性IgM抗体可用于SARS-CoV-2感染患者的辅助诊断。     

新型冠状病毒肺炎治疗后转归CT影像表现

目的对比观察新型冠状病毒肺炎(COVID-19)治疗前后影像变化,探讨其转归影像表现。方法回顾性分析24例COVID-19患者临床、实验室及治疗前后影像资料。结果轻型1例,胸部CT影像未见异常,白细胞、淋巴细胞计数、C反应蛋白未见异常,临床以咳嗽为主,治疗后症状消失。普通型15例,病变累及单个肺叶或多个肺叶,中外带、磨玻璃影为主,临床表现为普通型肺炎,肺内病灶治疗后2例(13. 3%)完全吸收,7例(46. 6%)明显吸收,6例(40%)部分有吸收,临床症状消失或减轻,白细胞、淋巴细胞计数全部恢复正常,C反应蛋白仍升高的4例(26. 7%)。重型8例,表现为双肺广泛分布的大片状实变影和/或磨玻璃密度影,临床表现为病情较重,治疗后明显吸收5例(62. 5%),部分吸收3例(37. 5%),临床症状减轻,白细胞、淋巴细胞计数全部恢复正常,C反应蛋白仍升高4例(50%)。结论 COVID-19以磨玻璃密度影及斑片状阴影为主,部分实变,影像表现多样,治疗后普通型患者病灶多明显吸收,重型患者多残留间质纤维化,影像表现滞后于临床。     

淋巴细胞亚群在新型冠状病毒肺炎患者外周血中的表达及临床意义

目的探讨淋巴细胞亚群在新型冠状病毒肺炎(COVID-19)患者外周血中的表达及临床意义。方法选取2020年1月18日至2月25重庆市长寿区人民医院收治的25例新型冠状病毒(SARS-CoV-2)核酸检测为阳性的患者为研究对象,其中21例有临床症状、确诊为COVID-19的患者为COVID-19组;4例无临床症状但SARS-CoV-2核酸检测为阳性的患者为无症状感染组;选取同期体检的20例健康者为对照组。检测各组淋巴细胞亚群,分析各组不同淋巴细胞水平的差异。结果 21例COVID-19患者中,18例患者的总淋巴细胞计数(Lym#)低于参考区间下限,3例患者的Lym#在正常参考区间内;20例患者的自然杀伤细胞计数(NK#)低于参考区间下限,1例患者的NK#在参考区间内。COVID-19组T淋巴细胞百分比、B淋巴细胞百分比高于对照组(P0.05),NK细胞百分比(NK%)、Lym#、T淋巴细胞计数、CD4~+T淋巴细胞计数、CD8~+T淋巴细胞计数、NK#低于对照组(P0.05)。COVID-19组NK#及NK%低于无症状感染组(P0.05)。结论 COVID-19患者存在淋巴细胞亚群水平异常,其中NK细胞下降显著;COVID-19组、无症状感染组与健康组淋巴细胞亚群水平存在差异,提示淋巴细胞亚群在COVID-19的诊断、病情评估中可能具有一定的临床价值。     

新型冠状病毒肺炎重型患者临床特征分析

目的:回顾性分析12例新型冠状病毒肺炎(COVID-19)重型患者的临床特征,总结诊治经验。方法:选取2020年1月到2020年2月在我院隔离3区收治的12例COVID-19重型患者为研究对象,通过观察临床症状、血常规淋巴细胞计数、氧合指数、肝肾功能、胸部CT的动态变化,分析其临床特征。结果:重型患者症状主要为发热(11例)、干咳(12例)、呼吸困难(9例)、乏力(11例)、纳差(11例);患者淋巴细胞计数绝对值明显下降,最低值(0.66±0.23)×10^9/L,持续(12.09±5.91)d;氧合指数下降明显,最低至(166.08±59.50)mmHg(1 mmHg=0.133 kPa),300 mmHg以下持续(10.00±4.95)d。早期胸部CT显示,双肺呈多叶多发斑片或片状磨玻璃;进展期阴影范围增多,部分实变,少数伴胸水;恢复期66.67%患者出现纤维条索影。结论:血常规淋巴细胞计数、氧合指数、早期胸部CT表现均为COVID-19重型患者诊断的重要指标,对早期诊治意义重大。     

多种血液学指标在新型冠状病毒肺炎中的诊断价值

目的观察分析新型冠状病毒肺炎(COVID-19)普通型患者和重症患者之间以及重症患者治疗过程中血常规指标、生化指标及D-二聚体(DD)检测结果的特点,为临床诊疗提供依据。方法回顾性分析296例COVID-19患者的各项检测指标,对其中30例重症患者治疗过程中的血常规指标、生化指标和DD进行动态观察。以100例普通肺炎患者作为对照组。结果COVID-19重症组淋巴细胞百分比(LYMPH%)、淋巴细胞绝对数(LYMPH#)、血小板(PLT)计数均低于COVID-19普通型组(P<0.05),中性粒细胞绝对数(NEUT#)、中性粒细胞/淋巴细胞比值(NLR)、天门冬氨酸氨基转移酶(AST)、尿素、肌酸激酶(CK)、乳酸脱氢酶(LDH)、DD均高于COVID-19普通型组(P<0.05)。与对照组比较,COVID-19重症组白细胞(WBC)计数、PLT计数、NEUT#、LYMPH#、LYMPH%均降低,NLR、LDH均升高(P<0.05);COVID-19普通型组WBC计数、PLT计数、NEUT#、NLR、LYMPH#、尿素、CK、DD、LDH均降低(P<0.05),LYMPH%升高(P<0.05)。30例重症患者中有7例病情加重或转危重,其WBC计数、NEUT#、NLR持续升高,LYMPH#持续降低。23例病情好转或病毒核酸转阴患者入院前期各项指标均异常,随后逐渐恢复正常。结论血常规指标、生化指标及DD检测结果对COVID-19的诊疗具有重要的参考价值。     

新型冠状病毒肺炎临床表现与影像学特征分析

目的:分析新型冠状病毒肺炎(COVID-19)的临床表现与影像学征象,提高对该病的认识。方法:回顾分析解放军总医院第五医学中心确诊的58例COVID-19患者的临床资料和胸部影像学表现。根据新型冠状病毒肺炎诊疗方案(试行第6版),将所有患者分为轻型(7例)、普通型(34例)、重型(7例)和危重型(10例)并分析影像学表现。结果:COVID-19患者常见临床表现为发热(47例,81.0%)、咳嗽(31例,53.4%)、乏力(10例,17.2%)。实验室检查:白细胞计数正常或减低52例(89.7%),淋巴细胞计数减低14例(24.1%),C-反应蛋白升高18例(31.0%)。CT表现为双下肺分布阴影(46例,90.2%),COVID-19普通型患者CT主要表现为磨玻璃影(23/34,67.6%)或混合型(17/34,50.0%),周边分布为主(28/34,82.4%),重型及危重型患者CT主要表现为实变(13/17,76.5%)及混合型(14/17,82.4%),周边及中心同时受累(14/17,82.4%)。其他常见征象包括胸膜平行征、晕征、血管增粗征、铺路石征、空气支气管征等。5例重型及危重型患者有胸腔积液。结论:COVID-19患者的胸部影像学表现具有一定特征,不仅能做为早期诊断参考,还能对临床病程及严重程度进行评估。     

365例COVID-19患者血常规分析

目的探讨新型冠状病毒肺炎(COVID-19)患者外周血细胞的变化规律,为治疗和防范提供指导意义。方法对365例COVID-19患者在住院当天、住院3~7 d、住院14~21 d的白细胞、淋巴细胞等指标分别检测,对3个不同时间的检测结果进行比较,观察COVID-19患者随病程进展血细胞的动态改变。结果365例COVID-19患者在住院3~7 d时白细胞计数最低,均值为4.78×10^9/L,中性粒细胞百分比均值为67.77%,与住院当天和住院14~21 d比较,差异均有统计学意义(P<0.05),与正常对照比较,差异也均有统计学意义(P<0.01);COVID-19患者住院3~7 d的淋巴细胞计数均值为1.07×10^9/L,百分比均值为22.75%,与住院当天和住院14~21 d比较,差异均有统计学意义(P<0.05),与正常对照比较,差异也均有统计学意义(P<0.01)。结论365例COVID-19患者在住院3~7 d白细胞计数最低,而淋巴细胞计数的降低更为明显。经过综合治疗14~21 d后,白细胞和淋巴细胞计数较住院3~7 d及住院当天均有上升,但仍未恢复至正常水平。     

血清IgG及亚类在原发干燥综合征中的意义

目的分析原发干燥综合征(pSS)患者血清IgG水平及其亚类分布特点和临床意义。方法回顾性分析2015年1月至2016年12月在首都医科大学附属北京友谊医院风湿科住院未经治疗的30例pSS患者的临床资料,应用免疫散射比浊法检测血清IgG和IgG亚类含量,根据血清IgG水平分为IgG升高组和IgG正常组。对比观察血清IgG升高组和IgG正常组的SSA抗体阳性比率、红细胞沉降率(ESR)、WBC计数、中性粒细胞(GR)计数、淋巴细胞(LY)计数、门冬氨酸氨基转移酶(AST),血红蛋白(HGB)、IgG4/IgG水平;SSA抗体阳性与SSA抗体阴性患者的IgG1水平。结果本组30例pSS患者中,26例为女性(86.7%),4例为男性(13.3%),年龄34~76岁,平均年龄(57.60±12.47)岁;有系统受累7例(23.3%),无系统受累23例(76.7%);63.3%患者血清IgG升高。与血清IgG正常的pSS患者相比,血清IgG升高组SSA抗体阳性比率、ESR、AST较高,WBC、GR、LY计数,HGB,IgG4/IgG水平较低(P0.05)。SSA抗体阳性pSS患者血清IgG1水平明显高于SSA抗体阴性患者。结论 pSS患者血清IgG升高常见,与多种自身抗体产生有关,参与疾病致病过程。抗SSA/SSB阳性患者血清IgG升高,抗SSA阳性pSS患者血清IgG1含量更高。     

Pulmonary fibrosis in critical ill patients recovered from COVID-19 pneumonia: Preliminary experience

ObjectiveTo investigate chest computed tomography (CT) findings associated with severe COVID-19 pneumonia in the early recovery period.MethodsWe retrospectively analyzed the cases of patients diagnosed with severe COVID-19 pneumonia at a single center between January 12, 2020, and March 16, 2020. The twelve ICU patients studied had been diagnosed SARS-CoV-2 (COVID-19) nucleic acid positive. Patient clinical symptoms were relieved or disappeared, and basic clinical information and laboratory test results were collected. The study focused on the most recent CT imaging characteristics.ResultsThe average age of the 12 patients was 58.8 ± 16.2 years. The most prevalent symptoms were fever (100%), dyspnea (100%), and cough (83.3%). All patients experienced acute respiratory distress syndrome (ARDS), of which 9 were moderate to severe. Six patients used noninvasive ventilators, and 4 patients used mechanical ventilation. One patient was treated with extracorporeal membrane oxygenation (ECMO). The lymphocyte count decreased to 0.67 ± 0.3 (× 10 ⁹/L). The average day from illness onset to the last follow-up CT was 56.1 ± 7.7 d. The CT results showed a decrease in ground glass opacities (GGO), whereas fibrosis gradually increased. The common CT features included GGO (10/12, 83.3%), subpleural line (10/12, 83.3%), fibrous stripes (12/12, 100%), and traction bronchiectasis (10/12, 83.3%). Eight patients (66.7%) showed predominant reticulation and interlobular thickening. Four patients (33.3%) showed predominant GGO. Lung segments involved were 174/216 (80.6%).ConclusionsFibrous stripes and GGO are common CT signs in critically ill patients with COVID-19 pneumonia in the early recovery period. Signs of pulmonary fibrosis in survivors should be carefully monitored.     

Treatment Effects of Integrated TCM and Western Medicine Treatment Scheme on COVID-19: A Single-armed Clinical Trial

BackgroudThe outbreak of COVID-19 has brought unprecedented perils to human health and raised public health concerns in more than two hundred countries. Safe and effective treatment scheme is needed urgently.ObjectiveTo evaluate the effects of integratedTCM and western medicine treatment scheme on COVID-19.MethodsA single-armed clinical trial was carried out in Hangzhou Xixi Hospital, an affiliated hospital with Zhejiang Chinese Medical University. 102 confirmed cases were screened out from 725 suspected cases and 93 of them were treated with integrated TCM and western medicine treatment scheme.Results83 cases were cured, 5 cases deteriorated, and 5 cases withdrew from the study. No deaths were reported. The mean relief time of fever, cough, diarrhea, and fatigue were (4.78 ± 4.61) days, (7.22 ± 4.99) days, (5.28 ± 3.39) days, and (5.28 ± 3.39) days, respectively. It took (14.84 ± 5.50) days for SARS-CoV-2 by nucleic acid amplification-based testing to turn negative. Multivariable cox regression analysis revealed that age, BMI, PISCT, BPC, AST, CK, BS, and UPRO were independent risk factors for COVID-19 treatment.ConclusionOur study suggested that integrated TCM and western medicine treatment scheme was effective for COVID-19.     

Do Patients With COVID-19 Benefit from Rehabilitation? Functional Outcomes of the First 100 Patients in a COVID-19 Rehabilitation Unit

ObjectiveTo determine the benefits associated with brief inpatient rehabilitation for coronavirus 2019 (COVID-19) patients.DesignRetrospective chart review.SettingA newly created specialized rehabilitation unit in a tertiary care medical center.ParticipantsConsecutive sample of patients (N=100) with COVID-19 infection admitted to rehabilitation.InterventionInpatient rehabilitation for postacute care COVID-19 patients.Main Outcome MeasuresMeasurements at admission and discharge comprised a Barthel Activities of Daily Living Index (including baseline value before COVID-19 infection), time to perform 10 sit-to-stands with associated cardiorespiratory changes, and grip strength (dynamometry). Correlations between these outcomes and the time spent in the intensive care unit (ICU) were explored.ResultsUpon admission to rehabilitation, 66% of the patients were men, the age was 66±22 years, mean delay from symptom onset was 20.4±10.0 days, body mass index was 26.0±5.4 kg/m², 49% had hypertension, 29% had diabetes, and 26% had more than 50% pulmonary damage on computed tomographic scans. The mean length of rehabilitation stay was 9.8±5.6 days. From admission to discharge, the Barthel index increased from 77.3±26.7 to 88.8±24.5 (P<.001), without recovering baseline values (94.5±16.2; P<.001). There was a 37% improvement in sit-to-stand frequency (0.27±0.16 to 0.37±0.16 Hz; P<.001), a 13% decrease in post-test respiratory rate (30.7±12.6 to 26.6±6.1; P=.03), and a 15% increase in grip strength (18.1±9.2 to 20.9±8.9 kg; P<.001). At both admission and discharge, Barthel score correlated with grip strength (ρ=0.39-0.66; P<.01), which negatively correlated with time spent in the ICU (ρ=–0.57 to –0.49; P<.05).ConclusionsInpatient rehabilitation for COVID-19 patients was associated with substantial motor, respiratory, and functional improvement, especially in severe cases, although there remained mild persistent autonomy loss upon discharge. After acute stages, COVID-19, primarily a respiratory disease, might convert into a motor impairment correlated with the time spent in intensive care.     

Epidemiological and clinical characteristics of 65 hospitalized patients with COVID-19 in Liaoning,China

BACKGROUNDCoronavirus disease 2019 (COVID-19) has spread rapidly to multiple countries through its infectious agent severe acute respiratory syndrome coronavirus 2. The severity, atypical clinical presentation, and lack of specific anti-viral treatments have posed a challenge for the diagnosis and treatment of COVID-19. Understanding the epidemiological and clinical characteristics of COVID-19 cases in different geographical areas is essential to improve the prognosis of COVID-19 patients and slow the spread of the disease.AIMTo investigate the epidemiological and clinical characteristics and main therapeutic strategy for confirmed COVID-19 patients hospitalized in Liaoning Province, China.METHODSAdult patients (n = 65) with confirmed COVID-19 were enrolled in this retrospective study from January 20 to February 29, 2020 in Liaoning Province, China. Pharyngeal swabs and sputum specimens were collected from the patients for the detection of severe acute respiratory syndrome coronavirus 2 nucleic acid. Patient demographic information and clinical data were collected from the medical records. Based on the severity of COVID-19, the patients were divided into nonsevere and severe groups. All patients were followed until March 20, 2020.RESULTSThe mean age of 65 COVID-19 patients was 45.5 ± 14.4 years, 56.9% were men, and 24.6% were severe cases. During the 14 d before symptom onset, 25 (38.5%) patients lived or stayed in Wuhan, whereas 8 (12.3%) had no clear history of exposure. Twenty-nine (44.6%) patients had at least one comorbidity; hypertension and diabetes were the most common comorbidities. Compared with nonsevere patients, severe patients had significantly lower lymphocyte counts [median value 1.3 × 10⁹/L (interquartile range 0.9-1.95) vs 0.82 × 10⁹/L (0.44-1.08), P < 0.001], elevated levels of lactate dehydrogenase [450 U/L (386-476) vs 707 U/L (592-980), P < 0.001] and C-reactive protein [6.1 mg/L (1.5-7.2) vs 52 mg/L (12.7-100.8), P < 0.001], and a prolonged median duration of viral shedding [19.5 d (16-21) vs 23.5 d (19.6-30.3), P = 0.001]. The overall median viral shedding time was 19.5 d, and the longest was 53 d. Severe patients were more frequently treated with lopinavir/ritonavir, antibiotics, glucocorticoid therapy, immunoglobulin, thymosin, and oxygen support. All patients were discharged following treatment in quarantine.CONCLUSIONOur findings may facilitate the identification of severe cases and inform clinical treatment and quarantine decisions regarding COVID-19.     

Comparison of hemoglobin level and neutrophil to lymphocyte ratio as prognostic markers in patients with COVID-19

BackgroundAnemia can negatively affect the outcome of many diseases, including infections and inflammatory conditions.AimTo compare the prognostic value of hemoglobin level and the neutrophil/lymphocyte ratio (NLR) for prediction of coronavirus disease 2019 (COVID-19) severity.MethodsIn this retrospective cohort study, clinical data from patients with laboratory-confirmed COVID-19 were collected from hospital records from 10 April 2020 to 30 July 2020.ResultsThe proportions of patients with mild, moderate, and severe COVID-19 differed significantly in association with hemoglobin levels, neutrophil counts, lymphocyte counts, NLR, and total leukocyte counts. Patients with severe COVID-19 had significantly lower hemoglobin levels than those with moderate or mild COVID-19. There were statistically significant negative associations between hemoglobin and D-dimer, age, and creatinine. The optimal hemoglobin cut-off value for prediction of disease severity was 11.6 g/dL. Using this cut-off value, hemoglobin had higher negative predictive value and sensitivity than NLR (92.4% and 51.3%, respectively). The specificity of hemoglobin as a prognostic marker was 79.3%.ConclusionBoth NLR and hemoglobin level are of prognostic value for predicting severity of COVID-19. However, hemoglobin level displayed higher sensitivity than NLR. Hemoglobin level should be assessed upon admission in all patients and closely monitored throughout the disease course.     

输入性新型冠状病毒肺炎临床和CT特征

目的 分析输入性新型冠状病毒肺炎（COVID-19）的临床和CT表现特点。方法 回顾性分析12例输入性COVID-19患者的临床及CT资料。结果 12例均有流行病学史，均发热，8例咳嗽；9例白细胞计数正常，7例淋巴细胞计数减少，5例C反应蛋白升高。CT显示双肺受累10例，单肺受累2例。2例病变局限于1个肺叶，3例累及2个肺叶，2例3个肺叶，5例累及双侧全肺；12例病变均主要在两肺外周胸膜下分布，2例呈单纯磨玻璃影（GGO），6例GGO伴实性成分、4例伴实变。病变形态为斑片影10例，类圆形2例。6例可见空气支气管征，4例见小叶间隔增粗，3例见纤维灶。12例均未见胸腔积液和淋巴结肿大。结论 COVID-19患者多有流行病学史，主要症状为发热、咳嗽，实验室检查白细胞计数多正常、粒细胞计数减低；CT多见两下肺外周多发GGO病变。     

妊娠合并新型冠状病毒肺炎临床特征分析

目的:探讨妊娠合并新型冠状病毒肺炎(COVID-19)患者的流行病学特点、临床特征及诊断。方法:回顾性分析2020年1月15日至2020年2月15日在华中科技大学同济医学院附属同济医院收治的22例妊娠合并COVID-19患者的临床资料,分析其流行病学特点、临床及放射学特征和实验室数据。结果:22例患者临床表现中有发热10例(45.45%)、咳嗽5例(22.73%)、呼吸急促1例(4.55%)和腹泻1例(4.55%)。21例(95.45%)为普通型,1例(4.55%)为重型。实验室检查中,淋巴细胞降低14例(63.64%),D-二聚体增高22例(100%)。胸部CT检查均示典型的COVID-19表现,病原学核酸检测阳性率40.91%(9/22)。结论:孕妇患COVID-19的临床特征和实验室检查与非妊娠成人患者相似,相对于病原学检查,胸部CT检查快速安全且敏感性高,更适合COVID-19流行地区产科急诊住院患者的初筛,同时能监测病情进展,有助于COVID-19孕妇的筛查、诊断及监测。