COVID-19患者的流行病学与临床特征

Epidemiological and clinical characteristics of patient with COVID-19

目的回顾性分析临沂市COVID-19患者的流行病学和临床特征,描述COVID-19的发生与演变过程,为防控策略提供科学依据。方法选取临沂市41例COVID-19患者为研究对象,其中轻型9例,普通型25例,重型及危重型7例,收集和分析患者的流行病学和临床特征数据。结果患者的中位年龄为41岁(31.6~53.6岁),男女比例1.56:1,中位体质量指数25.1 kg/m^2(22.4~27.6 kg/m^2),重型及危重型患者年龄更大、体质量更大、合并更多的基础疾病。有湖北旅居史者15例(36.6%),聚集性发病患者33例(80.5%),中位潜伏期6.5 d(4.0~11.5 d)。常见症状包括发热27例(65.9%)、干咳32例(78.0%),重型及危重型患者发热、咳痰、头痛头晕比例高于轻型(P<0.05)。重型及危重型患者血小板降低,谷草转氨酶、肌酐、肌红蛋白、肌钙蛋白升高(P<0.05)。影像学表现为单侧或双侧的多发斑片状影或磨玻璃影。重型及危重型患者应用抗病毒药物的数量、抗菌药物、糖皮质激素、丙种球蛋白、胸腺法新及氧疗法的比例更高(P<0.05)。结论既往合并多种基础疾病、高龄、肥胖的患者更易进展为重型或危重型,且可能导致多个系统或器官的异常。

Objective To analyze the epidemiology and clinical characteristics of patients with COVID-19, and provide reference for prevention and control strategies. Methods We selected 41 patients with COVID-19 of Linyi, including 9 patients with mild symptom, 25 patients with general symptom, 7 patients with severe and critical symptom. The epidemiological and clinical characteristics were analyzed. Results The median age was 41 years old(31.6-53.6 years old), the male to female ratio1.56:1, median BMI 25.1 kg/m^2(22.4-27.6 kg/m^2). The severe and critical patients were older, more obese, and had more underlying diseases. Fifteen cases(36.6%) were clearly related to Hubei, 33 clustered cases(80.5%), the median incubation period 6.5 d(4.0-11.5 d).The main first symptoms of the patients included fever(65.9%), dry cough(78.0%),the proportion of fever, sputum, and headache. The dizziness in severe and critical patients was significantly higher than that in mild group. For severe and critical patients, PLT was significantly reduced. AST, Cr, Myo, and cTnI were significantly increased. CT images showed multiple patchy shadows or ground glass shadows on one or both sides. The number of antiviral drugs, antibiotics,glucocorticoids, gamma globulin, thymus fascin and oxygen therapy were higher in severe and critical patients. Conclusions Patients with multiple underlying diseases, advanced age, and obesity are more likely to develop into severe or critical. It causes abnormalities in multiple systems or organs.