重庆市渝西地区新冠肺炎确诊病例首发症状及流行病学特征

 

目的 分析新型冠状病毒肺炎（简称新冠肺炎）确诊病例首发症状和流行病学特征，为制定新冠肺炎疫情防控措施提供理论依据。方法 选取重庆医科大学附属永川医院收治的90例新冠肺炎确诊患者，根据国家卫健委制定的《新型冠状病毒感染的肺炎病例流行病学调查方案》，对患者进行回顾性流行病学调查。结果 该院收治的90例确诊新冠肺炎患者均无野生动物接触史，武汉及周边地区旅居史（A型流行病学史）病例29例（32.22%）；有新型冠状病毒感染者接触史病例49例（54.44%），有病例报告社区的发热或有呼吸道症状的患者接触史12例（13.33%），均为B型流行病学史病例。聚集性发病73例（81.11%）。年龄为3~89岁，平均（48.19±17.85）岁。A型流行病学史病例主要集中在18~60岁，且以务工人员为主；B型流行病学史病例中≥60岁患者所占比例高于A型流行病学史病例，以农民为主。A、B型流行病学史两组患者不同年龄、职业构成比较，差异均有统计学意义（均P<0.05）。首发症状为发热及寒战（43例，47.78%）、咳嗽（干咳为主，27例，30.00%）等。发病初期有73例（81.11%）自行服药。患者患病前行为心理状态调查总均分为（15.16±7.64）分。A型流行病学史患者在知晓新型冠状病毒、了解防护措施、知晓开窗通风及室内消毒等方面优于B型流行病学史患者，差异均有统计学意义（均P<0.05）；B型流行病学史患者在知晓不去人口密集地方面优于A型流行病学史患者，差异有统计学意义（P<0.05）。结论 新冠肺炎具有早期散发，后期聚集性发病，人传人感染的强传染性。中老年人群为高发人群，新型冠状病毒感染与职业暴露密切相关，具有人群普遍易感性。早期诊断、早期隔离、综合治疗，积极控制慢性基础疾病对控制新冠肺炎病情至关重要。

Initial symptoms and epidemiological characteristics of confirmed cases of COVID-19 in the west of Chongqing

Objective To analyze the initial symptoms and epidemiological characteristics of confirmed cases of coronavirus disease 2019 (COVID-19), provide theoretical basis for formulating prevention and control measures for epidemic of COVID-19. Methods 90 patients confirmed with COVID-19 in Yongchuan Hospital of Chongqing Medical University were chosen, they were performed retrospective epidemiological survey according to Epidemiological survey program of COVID-19 cases formulated by National Health Commission of the People''s Republic of China. Results None of the 90 COVID-19 confirmed patients in this hospital had a history of contacting with wild animals, 29 cases (32.22%) had a history of sojourning in Wuhan and its surrounding areas (type A epidemiological history); 49 (54.44%) had a history of contacting with COVID-19 patients, 12 (13.33%) had a history of contacting with patients with fever or respiratory symptoms reported in community, all had type B epidemiological history. 73 cases (81.11%) were clustering onset of disease. Patients'' age was 3-89 years, the average age was (48.19±17.85) years. Type A epidemiological history mainly concentrated on patients of 18-60 years, mainly migrant workers; proportion of patients ≥ 60 years in type B epidemiological history cases was higher than that of type A epidemiological history cases, mainly farmers; there were significant differences in age and occupation between two groups of patients(both P<0.05). The initial symptoms were fever and chills (n=43, 47.78%), cough (mainly dry cough, n=27, 30.00%). 73 cases (81.11%) took medicine by themselves at the beginning of the disease. The total average score of premorbid behavioral and psychological status of patients was (15.16±7.64). Patients with type A epidemiological history were better than those in type B epidemiological history in terms of awareness on 2019-nCoV, understanding protective measures, awareness on windowing ventilation and indoor disinfection, diffe-rences were all statistically significant (all P<0.05); patients with type B epidemiological history were better than those with type A epidemiological history in terms of knowing not to go to densely populated areas, difference was statistically significant (P<0.05). Conclusion COVID-19 is highly infectious with early sporadic, late clustering onset and person-to-person transmission. The middle-aged and the elderly are the high incidence population, COVID-19 is closely related to occupational exposure, peoples are generally susceptible to it. Early diagnosis, early isolation, comprehensive treatment and active control of chronic underlying diseases are essential for controlling COVID-19.