新型冠状病毒肺炎的临床特征演变观察

Observation on the evolution of COVID-19 clinical features

目的:探讨新型冠状病毒肺炎(COVID-19)临床特征的演变。方法:回顾性分析2020年1月20日—2月18日惠州市中心人民医院诊治的56例COVID-19患者。收集患者人口学数据、流行病学史、临床表现、实验室检查及胸部HRCT表现等资料并进行分析。结果:COVID-19患者症状持续时间(11.25±5.26)d,以发热(85.71%)、干咳(51.79%)、乏力(32.14%)为主要表现;白细胞计数、中性粒细胞绝对值、血小板在疾病早期波动于正常范围低限,第8~14天回升(均P<0.05);血清淀粉样蛋白A、C反应蛋白、天冬氨酸转氨酶、乳酸脱氢酶、肌酸激酶、肌酸激酶同工酶均于第8~14天下降(均P<0.05)。第8~14天时,2例(3.57%)病灶范围较第4~7天增加,47例(83.93%)原有病灶范围缩小,2例(3.57%)出现新发病灶,仅2例(3.57%)病灶基本完全吸收消失。结论:COVID-19患者病程持续时间较长,住院第8~14天时,白细胞、中性粒细胞计数、血小板、心肌损伤、肺部影像才有改善,肺部病灶基本完全吸收消失的发生率低。

Objective:To investigate COVID-19 clinical characteristics of evolution.Methods:56 patients with COVID-19 diagnosed and treated in Huizhou Central People’s Hospital from January 20 to February 18,2020 were analyzed retrospectively.The data of demography,epidemiological history,clinical manifestation,laboratory examination and chest HRCT were collected and analyzed.Results:The duration of symptoms in patients with COVID-19 was(11.25±5.26)days,with fever(85.71%),dry cough(51.79%)and fatigue(32.14%)as the main manifestations.Leukocyte count,neutrophil absolute value and platelet fluctuated in the early stage of the disease to the lower limit of normal range,and increased on the 8th to 14th day(P<0.05);Serum amyloid A,C-reactive protein,aspartate transaminase,lactate dehydrogenase,creatine kinase and creatine kinase isoenzyme all decreased from the 8th day to the 14th day(P<0.05).From the 8th to the 14th day,only 2 cases(3.57%)of the original lesions were enlarged,47 cases(83.93%)of the original lesions were less absorbed than before,and only 2 cases(3.57%)whose lesions were basically completely absorbed and disappeared.Conclusion:The course of the disease of COVID-19 was long.The leukocyte,neutrophil count,platelet,myocardial injury and lung image were improved at the 8th to 14th day of hospitalization.The incidence of complete absorption and disappearance of lung lesions was low.