新型冠状病毒肺炎 4例早期临床特征分析

目的分析新型冠状病毒肺炎(coronavirus disease 2019，COVID-19)病人的早期临床特征，为临床早期识别该类病人提供依据。方法应用回顾性研究方法，分析 2020年 1—2月 4例经安徽医科大学附属巢湖医院诊治的 COVID-19病人的早期临床表现和影像学等资料。结果 4例病例中 2例男性， 2例女性，年龄范围为 26~64岁，中位数为 30岁。潜伏期在 1~6 d，均为输入性病例。 4例均有发热、咳嗽， 1例有头痛， 1例有全身酸痛、乏力， 3例脉搏增高， 3例血压增高。血常规中， 1例白细胞计数降低， 2例中性粒细胞计数降低， 1例淋巴细胞计数降低； 3例 C反应蛋白( CRP)、超敏 CRP升高， 1例降钙素原升高； 3例白球比例降低。 2例胸部 CT为两肺多发片状磨玻璃样影，分布在肺外周及胸膜下， 2例为单肺、单发扇形磨玻璃样影， 1例伴有片状实变影。结论早期 COVID-19病人有明显的流行病学史，临床表现不具有典型性，多表现为发热、咳嗽，外周血常规可正常或轻度异常，超敏 CRP和 CRP可见升高，影像学表现具有一定的特征性，表现为单肺、双肺多发或单发肺部磨玻璃影，部分伴有实变。

Analysis of early clinical manifestations of 4 patients with coronavirus disease 2019

Objective To analyze the early clinical characteristics of patients with coronavirus disease 2019 (COVID-19) to provide evidence for the early clinical identification of such patients.Methods A retrospective research method was used to analyze the early clinical manifestations and imaging data of 4 patients with COVID-19 who were diagnosed and treated by Chaohu Hospital Affiliated to Anhui Medical University from January to February 2020.Results The 4 patients included 2 males and 2 females, with an age rangeof 26 to 64 years and a median of 30 years. The incubation period is from 1 to 6 days, all of which are imported cases. All 4 patients hadfever and cough, 1 patient had headache, 1 patient had body aches and fatigue, 3 patients had increased pulse, and 3 patients had increased blood pressures. The routine blood results showed that the white blood cell count was decreased in 1 case, the neutrophil countwas decreased in 2 cases, and the lymphocyte count was decreased in 1 case. C-reactive protein (CRP) and high-sensitivity CRP wereincreased in 3 cases, procalcitonin (PCT) was increased in 1 case, and the proportion of globulin was decreased in 3 cases. Chest CTshowed multiple sheet-like ground-glass opacities in both lungs of 2 patients, distributed in the periphery of the lung and under thepleura, 2 cases were single lung, single fan-shaped ground-glass opacities, and 1 case was accompanied by sheet-like consolidation shadows.Conclusions Early COVID-19 patients have an obvious epidemiological history, and the clinical manifestations are not typical; most of them are fever and cough. Routine blood tests can be normal or mildly abnormal, hypersensitivity CRP and CRP can be increased, imaging manifestations have certain characteristics, including multiple or single lung ground-glass opacities in one lung or both lungs, and some are accompanied by consolidation.