新型冠状病毒肺炎伴腹泻70例的临床特征

Clinical characteristics of 70 patients with coronavirus disease 2019 accompanied with diarrhea

目的回顾性分析新型冠状病毒肺炎(COVID-19)伴腹泻患者的临床特征。方法收集2020年1月11日至2月6日武汉大学人民医院收治的663例COVID-19确诊患者的临床资料,根据是否伴有腹泻分为腹泻组和非腹泻组。比较两组患者基线特征、基础疾病史、临床表现、胸部CT表现、实验室检查结果、病情严重程度和死亡情况的差异。采用卡方检验和Fisher确切概率法进行统计学分析。结果663例COVID-19患者中,有70例(10.6%)患者伴有腹泻症状。腹泻组乏力和LDH水平升高的患者比例均高于非腹泻组[分别为58.6%(41/70)比28.2%(167/593)、64.2%(43/67)比50.4%(277/550)],差异均有统计学意义(χ2=26.891、4.566,P均<0.05)。腹泻组与非腹泻组有胸部CT肺炎表现者比例比较[100.0%(62/62)比99.4%(529/532)]差异无统计学意义(P>0.05)。腹泻组轻型和普通型、重型、危重型的患者比例与非腹泻组比较[分别为35.7%(25/70)比38.6%(229/593)、50.0%(35/70)比47.2%(280/593)、14.3%(10/70)比14.2%(84/593)]差异无统计学意义(P均>0.05)。腹泻组轻型和普通型、重型、危重型患者的死亡比例与相应临床分型的非腹泻组比较[分别为0比0.5%(3/593)、0比0、1.4%(1/70)比3.5%(21/593)]差异均无统计学意义(P均>0.05)。结论COVID-19伴腹泻患者更易出现乏力和LDH水平升高,腹泻与COVID-19患者的病情严重程度并无明显关联。

Objective To retrospectively analyze the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) accompanied with diarrhea.Methods From January 11 to February 6 in 2020, the clinical data of 663 patients diagnosed with COVID-19 admitted to Renmin Hospital of Wuhan University were collected and divided into diarrhea group and non-diarrhea group according to whether they had diarrhea or not. The differences in baseline characteristics, basic disease history, clinical manifestations, chest computed tomography (CT), laboratory findings, disease severity and mortality between the two groups were compared. Chi-square test and Fisher exact test were used for statistical analysis.Results Among 663 COVID-19 patients, 70 (10.6%) patients accompanied with diarrhea. The proportion of fatigue and increased lactate dehydrogenase (LDH) levels of diarrhea group were higher than those of non-diarrhea group (58.6%, 41/70 vs. 28.2%, 167/593;and 64.2%, 43/67 vs. 50.4%, 277/550), and the differences were statistically significant (χ2=26.891 and 4.566, both P<0.05). There was no statistically significant difference in the proportion of pneumonia in chest CT between diarrhea group and non-diarrhea group (100.0%, 62/62 vs. 99.4%, 529/532) (P>0.05). There were no statistically significant differences in the proportions of mild and normal type, severe type and critical type between diarrhea group and non-diarrhea group (35.7%, 25/70 vs. 38.6%, 229/593;50.0%, 35/70 vs. 47.2%, 280/593;and 14.3%, 10/70 vs. 14.2%, 84/593, respectively) (all P>0.05). There were no statistically significant differences in the mortality of mild and normal type, severe type and critical type between diarrhea group and non-diarrhea group (0 vs. 0.5%, 3/593;0 vs. 0 and 1.4%, 1/70 vs. 3.5%, 21/593) (all P>0.05).Conclusions Patients with COVID-19 accompanied with diarrhea are more likely to have fatigue and increased LDH level. Diarrhea is not significantly correlated with the disease severity of patients with COVID-19.