贵州省1例人类冠状病毒HKU1感染死亡病例流行病学调查

Death linked to human coronaviruses HKU1 infection in Guizhou province:a case report

目的分析贵州省1例感染人类冠状病毒HKU1(HCoV-HKU1)死亡病例的临床表现及流行病学调查结果,为感染HCoV-HKU1疾病的预防控制和诊疗提供参考依据。方法 2019年4月27日,云南省昆明市第三人民医院报告1例贵州省不明原因肺炎病例,经云南省疾病预防控制中心检测复核得贵州省盘州确诊1例HCoVHKU1感染病例。通过对病例进行流行病学调查,收集相关病历资料,开展相关实验室检测,应用描述性流行病学方法对病例的临床表现及实验室检测结果进行分析。结果死亡病例临床表现为发热、咳嗽、咳痰等症状,血常规检测早期白细胞数减少(2.4×10^9/L)、淋巴细胞数正常(1.8×10^9/L),后期白细胞增多(14.66×10^9/L)、淋巴细胞数正常(5.86×10^9/L),胸部CT检测结果显示双肺感染呈渐进性加重至肺实质改变,经实验室核酸检测确诊为人类冠状病毒HCoV-HKU1。经流行病学调查,感染来源不清,密切接触者未出现2代病例。结论这是贵州报告首例人类冠状病毒HCoV-HKU1感染死亡病例。

Objective To analyze clinical manifestations and epidemiological characteristics of a death case linked to human coronavirus HKU1(HCoV-HKU1) infection firstly reported in Guizhou province of China and to provide references for prevention of HCoV-HKU1 infection. Methods We conducted field surveys on a HCoV-HKU1 infection-related death among medical staff and family members of the death case. Information on clinical manifestations, exposure history, and laboratory detection of the death case were collected and analyzed using descriptive statistics. Medical observations were performed among close contacts of the case. Results A 51 years old female farmer visited a township hospital in Liupanshui city of Guizhou province on April 9, 2019 due to worsened pain, low fever, cough and sputum. The patient was then hospitalized and diagnosed with bilateral pulmonary inflammation change based on computed tomography at a municipal hospital in Liupanshui city on April 22. The patient were transferred to emergency department of the Third People’s Hospital of Kunming city, Yunnan province on April 27, 2019 and died of unexplained pneumonia and respiratory failure. Later on,the patient’s specimens of lower respiratory tract tissue were sampled and the specimens were HCoV-HKU1 nucleic acid positive according to the detection with real-time PCR performed at Kunming Municipal Center for Disease Control and Prevention and confirmed by the detection in Yunnan Provincial Center for Disease Control and Prevention. Major clinical manifestations of the case were fever, cough, and expectoration. Decrease in number of white blood cell(WBC, 2.4 × 10^9/L)was detected firstly and then both counts of WBC and lymphocytes increased(14.66 × 10^9/L and 5.86 × 10^9/L). No definite source of the infection was found based on the results of epidemiological surveys. There was no second-generation case was reported among the close contacts of the death case. Conclusion The case is the first death due to HCoV-HKU1 infection reported in Guizhou province.