北京65例新型冠状病毒肺炎患者临床特征分析

目的分析新型冠状病毒肺炎(COVID-19)确诊病例的流行病学、临床症状及实验室检查指标,为全面总结COVID-19的临床特征与正确评价患者预后提供依据。方法采用回顾性研究方法,以2020年1月20日-2月29日期间本中心收治的65例COVID-19患者为研究对象,根据临床症状将患者分为轻型组(18例),普通型组(31例)和重/危重型组(16例)3组,对所有患者流行病学、临床症状及实验室检查指标进行分析。结果65例COVID-19患者中男37例(57%),女28例(43%);年龄3~85岁,平均(46.63±18.63)岁。从出现症状到入院平均时长为(7.00±5.02)d,住院时间为(17.07±10.51)d。3组间及两两分组之间年龄比较差异均具有统计学意义(P均<0.05),即年龄越大的患者病情越重。相较于轻型组和普通型组患者,重/危重型组患者合并有更多的基础疾病。COVID-19患者临床症状以发热(75%)、咳嗽(57%)、肌痛或乏力(43%)为主,其余症状还包括咳痰,头痛,胸闷、气短及腹泻等。24例(37%)有武汉暴露史,19例(29%)有家族聚集性接触史。实验室检查结果显示:3组患者WBC和淋巴细胞绝对计数降低;D-二聚体,CRP,IL-6及ESR水平升高。在重/危重型组患者中,8例(50%)出现淋巴细胞绝对计数下降,9例(9/14,64%)出现D-二聚体水平升高。此外,重/危重型组患者中,CRP、IL-6、降钙素原和ESR水平都显著升高。COVID-19患者住院时间与淋巴细胞绝对计数呈负相关。结论COVID-19患者的临床特点复杂,一般以发热、咳嗽、肌痛或乏力为主要症状。与轻型组和普通型组患者相比,重/危重型组患者淋巴细胞绝对计数减少和炎症相关的指标上升更显著,免疫平衡失调,可能影响患者的疾病进展、恢复和预后。

Analysis on clinical characteristics of 65 COVID-19 patients in Beijing

Objective To analyze the epidemiology,clinical characteristics and laboratory testing parameters of novel coronavirus 2019(COVID-19)patients,and provide evidence for comprehensive summary of clinical characteristics of COVID-19 and proper evaluation of patient’s prognosis.Methods From January 20th to February 29th,2020,a total of 65 patients with COVID-19 admitted to our center were included in this retrospective study.The included patients were divided into 3 groups according to their clinical symptoms:mild group(n=18),common group(n=31)and severe/critical group(n=16).The epidemiology,clinical symptoms and laboratory testing parameters of all patients were analyzed.Results Among 65 COVID-19 patients,there were 37 men(57%)and 28 women(43%).Their age ranged 3-85 years,with a mean of(46.63±18.63)years.The average duration of symptoms before admission was(7.00±5.02)days and the length of hospital stay was(17.07±10.51)days.There were statistical differences in age among 3 groups and between every 2 groups(P<0.05).That is the older the patients were,the more severe the disease was.Severe/critical ill patients had more comorbidities of underlying diseases than mild and common patients.The clinical symptoms of COVID-19 patients were mainly fever(75%),cough(57%),myalgia or fatigue(43%).Other symptoms included expectoration,headache,fatigue,myalgia,shortness of breath,diarrhea,etc.Among them,24(37%)patients had a history of Wuhan exposure and 19(29%)patients had a familial cluster of infection.Laboratory testing results showed that absolute count of white blood cells and lymphocytes was decreased in all 3 groups of COVID-19 patients;the levels of D-dimer,CRP,IL-6,and ESR were increased.Among the severe/critical ill patients,8(50%)cases had a decrease in absolute number of lymphocytes,and 9(9/14,64%)cases had an increased level of D-dimer.In addition,CRP,IL-6,procalcitonin and ESR were significantly increased in severe/critical ill patients.The length of hospital stay was negatively correlated with the absolute number of lymphocytes in COVID-19 patients.Conclusions The clinical characteristics of COVID-19 are complicated and the main symptoms include fever,cough,myalgia or fatigue.Compared with mild and common patients,severe/critical ill patients exhibit significant lymphopenia and increased levels of inflammation-related indices.The dysregulation of the immune system may affect the progression,recovery and outcome of COVID-19 patients.