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。

Epidemiological and clinical characteristics of 35 cases of COVID-2019 pneumonia

Objective To explore the epidemiological characteristics,clinical manifestations,laboratory examination and imaging findings of patients with coronavirus(SARS-COV-2)pneumonia in 2019.Methods From January 28,2020 to February 24,2020,35 patients with pneumonia(COVID-19)infected by coronavirus in 2019 diagnosed by SARS-CoV-2 nucleic acid test in Liaocheng Infectious Disease Hospital of Shandong Province were collected.The information of epidemiology,age,time of onset,first symptom,blood routine,lymphocyte count,procalcitonin(PCT),serum amyloid protein A(SAA),C-reactive protein(CRP)and chest CT were collected and analyzed.Results 11%of the 35patients had a clear history of contact with Wuhan or other areas of Hubei,and 77%had no clear exposure history.83%were aggregative diseases,and 17%were imported cases.The average visit time was 5(0.00~8.00)d,43%of the patients had underlying diseases,71%of the patients had fever,60%of the initial symptoms were cough,and 14.3%of the initial symptoms were asymptomatic.In the laboratory examination,white blood cells were normal and decreased in 94.3%patients,lymphocyte count was decreased in 45.7%patients,SAA and CRP were increased in 74.3%and 45.7%patients,and PCT was normal in 14.3%patients.91.4%of the patients were positive for the first nucleic acid test,and 91.4%of the patients'chest CT showed multiple ground glass lesions in one or both lungs.91.4%of the patients were common type,and all patients were treated with aerosol inhalation ofα-interferon combined with lopinavir and ritonavir tablets,71.4%were treated with antibiotics and 14.3%were treated with hormones.All patients were improved and 22 patients were cured and discharged from hospital.Conclusion SRAR-COV-2 is highly infectious,family cluster infection may be the main mode of transmission in this city,common type is common,no specific changes in laboratory examination,and the disease is stable after treatment.