11例新型冠状病毒肺炎患者临床特征及预后分析

Clinical features and prognostic analysis of 11 patients diagnosed with COVID-19

目的:分析总结新型冠状病毒肺炎(corona virus disease 2019,COVID-19)患者在发热门诊就诊时的临床特征,比较不同住院时间组患者临床特征的差异。方法:对南京医科大学第一附属医院2020年1月20日—2月29日发热门诊筛查的11例COVID-19患者临床表现、实验室检查、影像学资料进行分析总结,并比较不同住院时间患者间临床特征的差异。结果:11例患者中合并基础疾病6例,发热及干咳是发生率最高的不适症状。7例淋巴细胞计数降低,肺部磨玻璃样渗出表现是最常见的胸部CT异常表现。与住院时间大于14 d相比,住院时间小于14 d的患者平均年龄更低,首次就诊前症状持续时间更短,中性粒细胞绝对计数及基础白蛋白水平较高,磨玻璃样浸润的肺叶数目更少,但由于样本量较少两组数据差异无统计学意义。结论:在发热门诊诊疗过程中需重视患者的流行病学史及胸部CT异常表现,同时警惕高龄及肺叶浸润数目较多可能是COVID-19患者需长时间住院的危险因素。

Objective:This study aims to analyze and summarize the clinical characteristics of patients infected with corona virus disease 2019(COVID-19)in fever clinic,and compare the differences in clinical characteristics of patients with different length of stay.Methods:The clinical manifestations,laboratory examinations and imaging data of 11 patients with COVID-19,who were diagnosed in the fever clinic of the First Affiliated Hospital of Nanjing Medical University from January 2,2020 to February 29,2020,were analyzed and summarized,and the differences of clinical characteristics among patients with different length of stay were compared.Results:Among the 11 patients,6 patients with underlying diseases,and 1 patient with a history of chronic smoking.The symptoms of fever and dry cough were the most common symptom.The lymphocyte count was decreased in 7 patients.The most common chest CT abnormality is the ground-glass exudation of the lungs.Compared with the patients with hospitalization time>14 days,the patients with hospitalization time≤14 days had a lower average age,shorter symptom duration before the first visit,higher absolute neutrophil count and basal albumin level,and less infiltrated pulmonary lobes.Due to the small sample size,there was no statistically significant differencebetweenthetwogroups.Conclusion:During the diagnosis and treatment of fever outpatients,it is necessary to pay attention to the patients’epidemiological history and abnormal CT manifestations of the chest.At the same time,it is necessary to be aware that the risk factors of long-term hospitalization for patients with COVID-19 may be the elderly age and the large number of pneumonia infiltration.