轻型新型冠状病毒肺炎患者临床特征分析

Clinical characteristics of patients with mild COVID-19

目的:分析轻型COVID-19患者的流行病学和临床特点。方法:对2020年1月21日至3月6日在浙江省多家医院收治的11例轻型COVID-19患者及117例非轻型患者进行回顾性分析,对比分析轻型患者在流行病学、人口学、临床表现和实验室检查方面的特征。结果:11例轻型COVID-19患者中位潜伏期为10(7~14)d,非轻型COVID-19患者为6(3~9)d,差异有统计学意义(Z=-4.520,P<0.001)。轻型组女性患者(8例)较男性(3例)多,与非轻型组相反。轻型组患者中位年龄(28岁)较非轻型组(48岁)小(Z=-4.070,P<0.001)。轻型组基础病史1例(占9.1%),非轻型组40例(占34.2%)。轻型组发热患者比例较非轻型组低(36.4%vs.73.5%,χ^2=4.984,P=0.026)。轻型组CRP升高患者比例较非轻型组低(9.1%vs.59.0%,χ^2=8.184,P=0.004)。2组白细胞减少患者比例相近。轻型患者接受氧气吸入治疗比例、糖皮质激素治疗比例较非轻型组低(36.4%vs.96.7%,0 vs.6%,均P<0.001)。截至2020年3月6日,10例(占90.9%)轻型患者已治愈出院,明显高于非轻型组(18例,占15.4%,P<0.001)。1例病情缓解,无死亡及加重病例。2组患者中位病程相近,但轻型组女性患者中位病程较男性短4 d。结论:轻型COVID-19患者表现隐匿,潜伏期长、症状轻、CRP正常率高、CT正常,可能引起漏诊,增加病毒传播风险。轻型患者预后好,但仍需综合治疗,密切观察。此外,女性轻型患者可能较男性多,且预后更好。

Objective:To analyze the epidemiology and clinical characteristics of patients with mild COVID-19.Methods:Retrospective analysis was performed on 11 patients with mild COVID-19 and 117 non-mild patients from multiple hospitals in Zhejiang Province from January 21 to March 6,2020.The characteristics of epidemiology,demography,clinical manifestations and laboratory examinations were analyzed.Results:The median incubation period was 10(7-14)days in 11 patients with mild COVID-19 and 6(3-9)days in non-mild covid-19,showing significant difference(Z=-4.520,P<0.001).There were more female patients(8 cases)than male patients(3 cases)in the mild group,which was contrary to the non-mild group.The median age of mild group(28 years old)was lower than that of non-mild group(48 years old)(Z=-4.070,P<0.001).One patient had coexisting disease(9.1%)in mild group while there were 40 patients(34.2%)in non-mild group.Patients with fever were fewer in mild group than in non-mild group(36.4%vs.73.5%,χ^2=4.984,P=0.026).The proportion of patients with elevated CRP in mild group was lower than that in non-mild group(9.1%vs.59.0%,χ^2=8.184,P=0.004).The proportion of leukopenia patients in the two groups was similar.The proportion of mild patients receiving oxygen inhalation treatment and glucocorticoid treatment was lower than that of non-mild patients(36.4%vs.96.7%,0%vs.6%,P<0.001).By March 6,2020,10 cases(90.9%)of mild patients had been cured and discharged,which was significantly higher than that of non-mild patients(18 cases,15.4%,P<0.001).There was no death or aggravation in mild patients.The median course of the two groups was similar,but the median course of the female patients in the mild group was shorter than that of the male for 4 days.Conclusion:Mild COVID-19 patients showed imperceptible,long incubation period,mild symptoms,high CRP normal rate,normal CT,which may cause missed diagnosis and increased risk of virus transmission.Though mild patients had good prognosis,but they still need comprehensive treatment and close observation.In addition,there may be more mild patients and better prognosis in women than in men.