2019冠状病毒病轻症患者的临床特点回顾

目的研究2019冠状病毒病(COVID-19)轻症患者的临床特点和核酸转阴时间。方法回顾性纳入2020年2月12日至2月29日武汉黄陂方舱医院的2019新型冠状病毒(2019-nCoV)核酸阳性的患者,分为轻型和普通型,随访至2020年3月10日,分析患者的临床特点和核酸检测结果。结果本研究共纳入75例患者,平均年龄41.2±11.5岁,男性占52.0%。患者中有发热表现者44.0%,CT影像阳性者54.7%。首次核酸检出阳性率69.3%,核酸转阴天数中位数为9.0天(6.0~14.0天)。随访至2020年3月10日,无患者转为重型或死亡。轻型(34例)和普通型(41例)患者的年龄、白细胞计数差异无显著性。与普通型组比较,轻型组女性占61.8%,显著高于男性(P<0.05);两组患者核酸转阴天数差异无显著性8.5天(7.0~13.8天)比9.0天(5.0~14.0天),P=0.973]。亚组分析发现轻型患者中,女性的核酸转阴时间少于男性(P=0.020),服用连花清瘟胶囊亚组核酸转阴时间缩短(P=0.026)。结论相同治疗下轻型和普通型患者核酸转阴时间差异无显著性,轻型患者中女性和服用连花清瘟亚组核酸转阴时间缩短;根据临床表现和影像学诊断COVID-19可能漏诊部分轻症患者,急需准确及时的核酸检测或其它病原学、血清学检测方法。

A retrospective analysis of clinical features of moderate patients with COVID-19

Aim To study the clinical characteristics and the time of nucleic acid conversion to negative in patients with Corona Virus Disease 2019(COVID-19).Methods This study is a retrospective study.Patients with laboratory-confirmed COVID-19 from a hospital in Wuhan from February 12,2020 to February 29,2020 were divided into mild and common types,followed up to March 10,2020,the clinical characteristics and nucleic acid test results of the patients were analyzed.Results A total of 75 patients were included in this study,with an average age of 41.2±11.5 years,and 52.0%were male.Among the patients,44.0%had fever and 54.7%had positive CT images.The positive rate of the first nucleic acid detection was 69.3%,and the median time of nucleic acid conversion to negative was 9.0 days(6.0~14.0 days).Follow-up to March 10,2020,no patients became severe or died.There were no significant differences in age and white blood cell count between patients with mild type(34 cases)and patients with common type(41 cases).Compared with the common group,women in the wild group accounted for 61.8%,which was significantly higher than men(P<0.05);there was no statistical difference in the time required for nucleic acid conversion to negative between the two groups(8.5(7.0~13.8)vs 9.0(5.0~14.0),P=0.973).The subgroup analysis found that in mild patients,women had less nucleic acid conversion time than men(P=0.020),and the Lianhuaqingwen capsule subgroup had less nucleic acid conversion time(P=0.026).Conclusions There was no significant difference in the time of nucleic acid conversion to negative between mild and common patients under the same treatment,and the time of nucleic acid conversion for females and the patients taking Lianhuaqingwen was shortened in mild group.Many patients with moderate COVID-19 may be missed based on clinical manifestations and imaging findings,and accurate and prompt nucleic acid testing or other etiological determination methods are needed.