新型冠状病毒肺炎患者382例早期临床特征分析

Clinical characteristics of 382 hospitalized patients with COVID⁃19

目的总结新型冠状病毒肺炎(COVID-19)患者的早期临床特征,为病情的诊断、治疗提供科学依据。方法回顾性分析2020年1月24日至3月1日武汉济和医院382例确诊为COVID-19患者的临床资料,比较不同临床分型病例的一般情况、临床表现、实验室检查结果。结果 382例COVID-19住院患者中,普通型285例(74.6%),重型63例(16.5%),危重型34例(8.9%),其中男190例,女192例,平均年龄(52.0±14.1)岁,124例(32.5%)患者合并高血压、糖尿病、冠心病等1种或以上基础疾病,主要临床表现为发热369例(96.6%)、咳嗽356例(93.2%)、乏力325例(85.1%),3组患者在乏力、气促和胸闷等症状上的差异有统计学意义(均P<0.01),与普通型患者相比,重型及危重型患者淋巴细胞(L)、白蛋白(ALB)显著降低(均P<0.01),重型及危重型患者凝血酶原时间(PT)、活化部分凝血酶时间(APTT)、D-二聚体(D-Dimer)、超敏C反应蛋白(HCRP)、血沉(ESR)、天门冬氨酸氨基转移酶(AST)、β2-微球蛋白(β2-MG)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、心肌肌钙蛋白I(cTnI)较普通型明显升高(均P<0.01)。结论 COVID-19患者高龄及合并基础疾病者更易发展成为重型及危重型,且常并发血液、凝血、肝、肾、心等器官功能损伤,临床治疗中应加强多学科合作。

Objective This study aimed to analyze clinical characteristics of early COVID⁃19 and provide evidence for early diagnosis and management for COVID⁃19.Methods The clinical date of 382 patients with com⁃mon and severe type COVID⁃19 in Jihe Hospital of Wuhan from January 24,2020 to March 1 were retrospectively summarized.Results According to the guideline for Diagnosis and Treatment of Novel Coronavirus Infected Pneu⁃monia,382 patients were divided into common group(n=285,74.6%),severe group(n=63,16.5%)and criti⁃cal group(n=34,8.9%).There were 190 male and 192 female patients.The average age was(52.0±14.1)years old.There were 124 of them complicated with one or more basic diseases,such as hypertension,diabetes,coro⁃nary heart disease.The most common symptoms were fever(96.6%),cough(93.2%),and fatigue(85.1%),There were significant differences in the incidence of fatigue,anhelation and chest distress among the three groups(P<0.01).Compared with those in common group,the LYM and ALB of the severe and the critical patients were significantly lower(P<0.01).And the serum levels of PT,APTT,D⁃Dimer,HCRP,ESR,AST,β2⁃MG,CK,CK⁃MB,LDH and cTnI were significantly increased in severe and critical groups(P<0.01).Conclusions The el⁃derly patients with hypertension,diabetes and coronary heart disease are more prone to develop into severe and criti⁃cally ill,and often complicated by functional impairment of organs such as blood,coagulation,liver,kidney,and heart.Multidisciplinary cooperation should be strengthened in clinical treatment.