61例新型冠状病毒肺炎患者出院后随访调查分析

目的分析新型冠状病毒肺炎患者出院后的临床特征。方法选择海南省人民医院感染科2020年1月20日—3月24日治愈出院的61例新型冠状病毒肺炎患者,收集其出院前、出院后2周、出院后4周的临床表现、实验室检查、影像学转归等临床资料,将3次结果作对比分析。结果所有出院患者无再发热、腹泻症状,无传染他人,个别患者仍有乏力、咳嗽症状,均较前减轻;有7例患者出现核酸检测复阳,6例短期内转阴,1例持续时间稍长;出院时有14例患者淋巴细胞数仍减少,4周后只有3例仍有减少,且有不同程度的升高,差异有统计学意义(P<0.05);大部分患者肺部病灶明显吸收、有9例仍见局部纤维化,另外7例患者病灶吸收缓慢。结论新型冠状病毒肺炎患者临床治愈出院后,大部分患者可较快恢复至发病前状态,淋巴细胞计数及胸部影像学表现可基本恢复正常,肺纤维化病灶也可逐渐吸收,部分治愈者可出现核酸检测复阳,但无相应临床症状及影像学表现,其意义有待进一步探讨。

Follow-up investigation analysis of 61 discharged patients with COVID-19

Objective To investigate and analyze the clinical characteristics of discharged patients with coronavirus disease 2019(COVID-19).Methods A total of 61 patients with COVID-19 who were discharged from the Infectious Department of Hainan General Hospital from Jan 20 to Mar 24, 2020 were recruited as the study objects, the clinical symptoms, result of clinical laboratory tests and imaging data were observed and compared at different stages- before discharge, two weeks after discharge and four weeks after discharge.Results None of the 61 patients had the symptoms of fever, diarrhea, none of them infected other people,some patients had the symptoms of fatigue and cough, these symptoms were all improved gradually; The nucleic acid test was positive again in 7 patients, 6 of them turned negative in short time, 1 case lasted for longer days before turning negative; 14 patients had a low lymphocyte count before discharge, only 3 cases still low after four weeks, and most of them increased at different level, the difference was statistically significant（P<0.05）; most patients′lung lesions were absorbed obviously, 9 of them had fibrotic lesions four weeks after discharge, the other 7 patients′were absorbed slowly.Conclusion Most of COVID-19 patients have a good prognosis and return to premorbid state, total lymphocyte count and chest imaging features can nearly back to normal, pulmonary fibrosis almost absorbed, part of these patients′nucleic acid test were positive again, but they didn′t have clinical symptoms and characteristic appearances on imaging, so it′s meaning needs further investigation.