新型冠状病毒肺炎病例流行特征及临床特征分析

目的 分析新型冠状病毒肺炎（COVID-19）流行病学特征、临床特点及CT影像变化,为当地疫情防治提供参考依据。方法 收集商城县人民医院和罗山县人民医院2020年1月23日至2月23日收治的所有COVID-19确诊病例的病历资料及影像学资料。采用描述流行病学分析方法进行分析。结果 共收治确诊COVID-19病例50例,男女性别比为1.38∶1,平均年龄为（50.92 ± 14.63）岁,其中45~64岁31例（占62%）。39例（占78%）具有流行病学暴露史,11例（占22%）无明确的流行病学暴露史。有6起家族聚集发病现象,共涉及13例病例。潜伏期1~23 d,平均为（5.95 ± 4.24）d。发热（占84%）和咳嗽（占72%）是该病例人群主要症状。入院时43例（占86%）白细胞计数正常或者淋巴细胞计数绝对值减少,40例（占80%）红细胞沉降率增快,26例（占52%）C反应蛋白升高。15例（占30%）合并原发基础疾病。40例（占80%）使用2种及以上抗病毒药物。入院2周后40例（占80%）CT显示病灶逐渐吸收。结论 多数患者具有明确的流行病学暴露史,存在家族聚集性发病现象,临床症状以发热、咳嗽为主,白细胞正常或者减少、血沉增快较多见,对临床诊断具有参考价值,CT表现病灶面积呈先扩大后逐渐吸收的变化趋势,积极抗病毒及对症治疗症状多能好转。

Epidemiological and clinical characteristics of COVID-19 cases

Objective To analyze the epidemiological and clinical characteristics, and CT image changes of COVID-19 cases, so as to provide reference for local prevention and treatment.Methods Medical records and CT imaging data of all confirmed COVID-19 cases were collected from People's Hospitals of Shangcheng and Luoshan counties during January 23 to February 23, 2020. Descriptive epidemiological analysis method was used to analyze the data.Results Fifty COVID-19 cases were diagnosed. The male to female sex ratio was 1.38∶1. The average age was 50.92 ± 14.63 years. Of the cases, 31 （62%） were aged 45-64 years, 39 （78%） had epidemiological exposure history, 11 （22%） had no definite history of epidemiological exposure. Six family-clustered outbreaks occurred, involving 13 patients. The incubation period was 1-23 days, with an average of 5.95 ± 4.24 days. The main symptoms of the cases were fever （84%） and cough （72%）. On admission, 43 cases （86%） had normal white blood cell （WBC） count or decreased absolute lymphocyte count, 40 cases （80%） had elevated erythrocyte sedimentation rate （ESR） and 26 cases （52%） had elevated C-reactive protein （CRP）; 15 cases （30%） were complicated with primary underlying diseases. Forty patients （80%） were administered with two or more antiviral drugs. Two weeks after admission, 40 cases （80%） showed that the lesion area was gradually reduced on CT images.Conclusion Most patients have a clear history of epidemiological exposure, family-clustered outbreaks occurred, and the main clinical symptoms are fever and cough. Normal or decreased WBCs and elevated ESR are more common, which has reference value for clinical diagnosis. CT shows that the lesion area is enlarged first and then gradually absorbed. Active antiviral and symptomatic treatment can improve the symptoms.