河南省新型冠状病毒肺炎排除病例和确诊病例分析

摘要：目的 比较河南省新型冠状病毒肺炎确诊病例和排除病例的流行病学和临床特征。方法 选取截至 2020年2月20日中国疾病预防控制信息系统报告的河南省新型冠状病毒肺炎确诊病例和已排除病例，结合传染病 报告卡和个案调查，描述分析流行病学和临床特征。结果 共收集5 635例，其中新型冠状病毒肺炎确诊病例1 267 例，疑似排除病例4 368例。确诊病例中位年龄大于排除病例（45岁 vs. 34岁，Z=14.857，P＜0.01）。确诊病例中有武 汉及周边地区旅居史、与确诊病例或无症状感染者接触史、与来自武汉及周边地区人群接触史、涉及聚集性疫情等 暴露史比例均高于排除病例（P＜0.01），而暴露史不明确的比例低于排除病例（P＜0.01）。确诊病例和排除病例中重 症比例分别为11.6%和2.6%，差异有统计学意义（χ2=149.938，P＜0.01）。确诊病例中有慢性基础性疾病、发热、干咳、 乏力、胸闷、腹泻、白细胞正常或减少、淋巴细胞减少、胸部CT异常比例高于排除病例（P＜0.01）。结论 对新型冠状 病毒肺炎病例进行确诊和排除时，除了病原检测结果，应综合考虑流行病学史及临床表现

Analysis of excluded and confirmed cases of COVID-19 in Henan province

Abstract：Objective To compare the epidemiological and clinical characteristics of confirmed and excluded patients of coronavirus disease 2019 (COVID-19) in Henan province. Methods All excluded and confirmed cases of COVID-19 reported in Henan province up to February 20, 2020 were selected in this study. Epidemiological and clinical characteristics were analyzed according to infectious disease report cards and individual case investigations. Results A total of 5 635 COVID-19 cases were collected in Henan province, including 1 267 confirmed cases and 4 368 suspected excluded cases. The median age of confirmed cases (45 years) was greater than the median age of excluded cases (34 years, Z=14.857, P＜ 0.01). The proportions of sojourning in Wuhan and its surrounding areas, contacting with cases or asymptomatic cases, contacting with people from Wuhan and surrounding areas and involving in a clustered epidemic were higher in confirmed cases than those in excluded cases (P＜0.01), while the proportion of unknown exposures was lower in confirmed cases than that in excluded cases (P＜0.01). The proportion of severe cases in confirmed and excluded cases were 11.6% and 2.6% respectively, and the difference was statistically significant (χ2=149.938, P＜0.01). The percentages of chronic underlying diseases, fever, dry cough, fatigue, chest tightness, diarrhea, normal or decreased white blood cells and lymphocytes, and chest CT abnormalities were higher in confirmed cases than those in excluded cases (P＜0.01). Conclusion In addition to pathogen test results, epidemiologic history and clinical presentation should be taken into account in the diagnosis and exclusion of COVID-19