宝山区报告的34例新型冠状病毒肺炎确诊病例临床和流行病学特征分析

目的分析上海市宝山区报告的所有新型冠状病毒肺炎确诊病例临床和流行病学特征,为防控新型冠状病毒肺炎疫情提供科学依据。方法根据《新型冠状病毒肺炎防控方案(第四版)》对2020年1月19日—2月29日报告的上海市宝山区新型冠状病毒肺炎确诊病例临床和流行病学特征进行描述和分析。结果宝山区辖区医疗机构共报告34例确诊病例,31例为轻症和普通型病例(91.18%),2例危重症病例和1例重症病例。家庭聚集性疫情6起,涉及病例23例,占总数的67.65%。34例病例男女比例1∶1.27;年龄范围1~84岁,中位数53.5岁,其中>40岁19例,占55.88%;职业以离退休人员和职员为主,分别占35.29%和26.47%。34例病中有33例均有明确感染来源,其中与湖北相关病例14例(41.18%),与确诊病例接触19例(55.88%)。1月份病例与湖北相关为主(57.89%),2月份与确诊病例接触为主(80.00%),主要来源家庭聚集性疫情。临床表现以发热、咳嗽、咽痛等呼吸道症状为主,2例(5.88%)病例有腹泻等消化道症状。发病到首次就诊间隔时间中位数为2 d(0~13 d),35.29%的病例在首次就诊时未诊断新型冠状病毒肺炎。发病到疑似病例诊断隔离时间的中位数为3 d(0~17 d)。发病到确诊间隔时间中位数为4 d(0~18 d)。结论病例以轻症和普通型病例为主,人群普遍易感。上海市宝山区早期病例多与湖北相关,且发病到疑似病例诊断隔离时间较长。超半数病例多因共同生活和密切接触导致聚集性发病。需进一步加强对公众的健康教育和卫生技术人员培训,提高病例诊断敏感性。

Clinical and epidemiological characteristics of 34 COVID-19 confirmed cases reported in Baoshan District

Objective To analyze the clinical and epidemiological features of all coronavirus disease-2019 (COVID-19) confirmed cases reported in Baoshan District, Shanghai Municipality, and to provide a scientific basis for prevention and control of the COVID-19 epidemic. Methods According to Protocol for Prevention and Control of COVID-19 (Edition 4), the clinical and epidemiological characteristics of the COVID-19 confirmed cases in Baoshan District of Shanghai Municipality reported from January 19 to February 29, 2020 were described and analyzed. Results A total of 34 confirmed cases were reported by medical institutions of Baoshan District, including 31 mild and moderate cases (91.18%), 2 severe cases and 1 critical case. There were 6 clusters of household transmission, involving 23 cases and accounting for 67.65% of the total cases. The male to female sex ratio in the 34 cases was 1:1.27. The cases were aged between 1 and 80 years, and the median age was 53.5 years. 19 cases were aged above 40 years, accounting for 55.88%. Most of the cases were retirees and staff, accounting for 35.29% and 26.47% respectively. Among the 34 cases, 33 cases had definite sources of infection, among which 14 cases were related to Hubei (41.18%) and 19 cases were contacted with confirmed cases (55.88%). The cases in January were mainly related to Hubei (57.89%), but majority of the cases in February were associated with contacting confirmed cases (80.00%), mainly from the family clustering epidemic. The main clinical manifestations were fever, cough, sore throat and other respiratory tract symptoms. 2 (5.88%) cases had diarrhea and other gastrointestinal symptoms. The median interval from onset to first medical visit was 2 days (0-13 days), and 35.29% of the cases were not diagnosed as COVID-19 at first medical visit. The median interval from onset to diagnosis of suspected case was 3 days (0-17 days). The median interval from onset to confirmed diagnosis was 4 days (0-18 days). Conclusion The cases were mainly mild and common type, and the populations were generally susceptible. Most of the early cases in Baoshan District of Shanghai Municipality were related to Hubei Province, and the time from onset to diagnosis of suspected case was long. More than half of the cases were caused byliving together andclose contact. It is necessary to further strengthen the public health education and the training of medical professionals so as to improve the sensitivity of case diagnosis.