重庆地区新型冠状病毒肺炎153例临床特征分析

目的分析重庆地区153例新型冠状病毒肺炎(COVID-19)患者的临床资料,为该疾病的诊疗提供借鉴和思考。方法收集2020年1月26日至2月5日在重庆市公共卫生医疗救治中心收治的153例COVID-19患者的临床资料。根据疾病严重程度,分为非重症组(n=132)和重症组(n=21),分析两组患者的临床表现、实验室检查、胸部影像学特征、治疗和转归情况。采用SPSS 23.0统计软件进行数据分析。结果重症组患者合并糖尿病和慢性呼吸系统疾病的比例均高于非重症组(χ2=11.04和6.94,P<0.05)。在首发症状中,非重症组患者有22例(16.7%)无症状,与重症组患者比较,差异具有统计学意义(χ2=4.09,P<0.05)。重症组患者发热、乏力和肌肉酸痛的比例高于非重症组(χ2=4.40、14.42和22.67,P<0.05)。在伴随症状中,重症组患者咳痰和气促的比例高于非重症组(χ2=8.46和4.80,P<0.05)。重症组患者C-反应蛋白、D-二聚体高于非重症组(Z=-4.39和-1.96,P<0.05),CD3+T、CD4+T和CD8+T淋巴细胞计数均低于非重症组(Z=27.25、20.60和17.36,P<0.05)。重症组患者双肺多叶、右肺下叶受累比例高于非重症组患者(χ2=9.71和23.61,P<0.05)。结论COVID-19的严重程度与患者合并基础疾病、临床症状、肺脏受累部位、C-反应蛋白、D-二聚体、CD3+T淋巴细胞计数、CD4+T淋巴细胞计数及CD8+T淋巴细胞计数相关。

Clinical features of 153 patients with COVID-19 in Chongqing municipality

Objective To analyze the clinical features of patients with COVID-19 in Chongqing Municipality.Methods The clinical data,laboratory tests and chest imaging findings of 153 patients COVID-19 admitted in Chongqing Public Health Medical Center from January 26 to February 5,2020 were retrospectively reviewed.According to the relevant diagnostic criteria,patients were divided into non-severe group(n=132)and severe group(n=21).The correlation between serum index changes and disease severity was analyzed.Results The proportion of patients with underlying diabetes or chronic respiratory diseases in severe group was significantly higher than that in non-severe group(χ2=11.04 and 6.94,P<0.05).The proportion of symptom-free patients in non-severe group was significantly higher than that in severe group(χ2=4.09,P<0.05).The symptoms of fever,fatigue and muscle soreness in the severe group were more common than those in the non-severe group(χ2=4.40,14.42 and 22.67,P<0.05).Among the concomitant symptoms,the proportion of cough and shortness of breath in the severe group was higher than that in the non-severe group(χ2=8.46 and 4.80,P<0.05).C-reactive protein and D-Dimer levels were higher in the severe group than those in the non-severe group(Z=-4.39 and-1.96,P<0.05),and the number of CD3+T lymphocyte cells,CD4+T lymphocyte cells and CD8+T lymphocyte cells in the severe group was lower than that in the non-severe group(Z=27.25,20.60 and 17.36,P<0.05).Compared with the non-severe group,both lungs and the right lung lower lobe were more susceptible to be involved(χ2=9.71和23.61,P<0.05).Conclusions There are significant differences in underlying diseases,clinical symptoms,imaging manifestations and laboratory findings between severe and non-severe patients with COVID-19.