57例新型冠状病毒肺炎患者的临床和流行病学特征分析

An analysis of clinical and epidemiological characteristics of 57 cases with coronavirus disease 2019

目的分析57例新型冠状病毒肺炎确诊患者的临床和流行病学特征。方法根据国家卫生健康委员会《新型冠状病毒肺炎病例流行病学调查方案》,对2020年1月31日-2月24日57例新型冠状病毒肺炎患者进行流行病学调查。57例确诊患者采集了咽拭子,部分患者同时采集了痰标本;57例患者行实时荧光RT-PCR检测新型冠状病毒核酸均呈阳性。结果男、女患者比例为1∶1.48,年龄8~77(47.81±16.19)岁。城区与农村发病差异不大。发病时间为2020年1月21日-2月19日,确诊时间为2020年1月31日-2月22日。某百货大楼暴露史24例(42.11%),接触确诊患者28例(49.12%);聚集性发病事件3起,发病例数55例(96.49%),其中某百货大楼相关聚集性患者41例(71.93%),某村聚集性患者10例(17.54%),某学校教师及家属聚集性患者4例(7.02%)。临床严重程度:普通型32例(56.14%),重型21例(36.84%),危重型4例(7.02%)。主要临床表现:发热48例(84.21%),干咳16例(28.07%),乏力9例(15.79%),咽痛4例(7.02%),腹泻3例(5.26%),胸闷3例(5.26%),肌肉酸痛2例(3.51%);白细胞计数正常者52例(91.23%),淋巴细胞绝对值降低者24例(42.11%);肺部CT检查影像学改变53例(92.98%)。1次核酸检测阳性35例(61.40%)。结论新型冠状病毒肺炎患者以女性、聚集性发病为主;临床以普通型为主,以发热、干咳、乏力、咽痛、腹泻、胸闷、肌肉酸痛等为主要症状;大部分患者白细胞计数正常,部分患者淋巴细胞绝对值降低,绝大多数有影像学改变。

Objective To analyze the clinical and epidemiological characteristics of 57 confirmed cases with coronavirus disease 2019.Methods According to the epidemiology investigation program of coronavirus disease 2019 issued by National Health Commission,the epidemiological survey of 57 patients with coronavirus disease 2019 was conducted from January 31 to February 24,2020.The throat swab was collected in 57 patients,and the sputum specimens were collected in part of the patients.The fluorescent RT-PCR showed that all the nucleic acid tests for 2019 novel coronavirus were positive.Results The ratio of male to female was 1∶1.48,and the age was 8-77(47.81±16.19)years old.There was no significant difference in the cases of coronavirus disease 2019 between urban and rural areas.The onset time was from January 21 to February 19,and the diagnosis time was from January 31 to February 22,2020.A total of 24 cases(42.11%)had been exposed to the department store,28 cases(49.12%)had been contacted with the diagnosis.There were 55 cases(96.49%)in 3 clustered events,including 41 cases(71.93%)related to department stores,10 cases(17.54%)related to a village,and 4 cases(7.02%)related to teachers and family members of a school.According to the standard of clinical severity,32 cases(56.14%)were classed as common type,21 cases(36.84%)were classed as heavy type,and 4 cases(7.02%)were classed as critical type.The main clinical manifestations were fever in 48 cases(84.21%),dry cough in 16 cases(28.07%),asthenia in 9 cases(15.79%),pharyngeal pain in 4 cases(7.02%),diarrhea in 3 cases(5.26%),chest distress in 3 cases(5.26%)and muscle ache in 2 cases(3.51%).The blood routine examination showed that the white blood cell count was normal in 52 cases(91.23%),and lymphocyte absolute value was decreased in 24 cases(42.11%).The pulmonary CT examination represented the imaging was changed in 53 cases(92.98%).There was 35 cases(61.40%)with positive nucleic acid test only by one time.Conclusion The cases with coronavirus disease 2019 are mainly female and aggregative.The major clinical symptoms are fever,dry cough,asthenia,pharyngeal pain,diarrhea,chest distress and muscle ache.Most of the patients have normal white blood cell count,and part of them have decreased lymphocyte absolute value.A majority of the cases have imaging changes.