一起聚集性发病的新型冠状病毒肺炎患者临床和流行病学特征分析

Analysis of clinical and epidemiological characteristics of a cluster case of COVID-19 patients

目的分析浙江一起宗教大型集会活动导致的聚集性新型冠状病毒肺炎的临床表现及流行病学特征,加强对新型冠状病毒感染具有聚集、暴发流行性的认识,从而有效控制其传播。方法收集浙江2020年1-2月份新型冠状病毒肺炎聚集性发病中21例肺炎病例并回顾性分析其临床及流行病学特征。结果21例患者均为中老年女性,年龄(58.94±7.45)岁,10例(47.6%)有基础疾病,仅有1例患者被诊断为重症病例,其余均为轻症,期间没有患者死亡。发病时最常见的症状为发热[19(90.5%)],咳嗽[15(71.4%)],咳痰[9(42.8%)],少见症状包括乏力[1(4.7%)]、腹泻[1(4.7%)]及头疼[1(4.7%)],从接触到疾病发作的中位时间为7(3~11.5)天。入院时57.14%(12/21)的患者白蛋白减少,42.85%(9/21)的患者钠离子减少,38.09%(8/21)的患者尿素氮降低,28.57%(6/21)的患者淋巴细胞减少及各14.28%(3/21)的患者钾离子、白细胞减少,另外,血糖、C反应蛋白、血清乳酸脱氢酶、转氨酶升高的患者分别占61.90%(13/21)、61.90%(13/21)、33.33%(7/21)、23.80%(5/21).所有患者入院时肺部CT检查均有异常改变,影像学多表现为以磨玻璃/斑片样改变为主的双侧肺部感染。结论本起聚集性病例起病以中老年女性为主,群体聚集可导致新型冠状病毒的传播扩散,且新型冠状病毒老年人更加易感,非常时期应限制大型集会,减少人员流动、减少接触,有助于疾病控制。

Objective To analyze the clinical manifestations and epidemiological characteristics of a cluster case of COVID-19 caused by a large religious gathering in Zhejiang,and to strengthen the awareness of the clustering and outbreak epidemic of the COVID-19 infection,so as to effectively control its spread.Methods 21 cases of pneumonia in the clustered incidence of COVID-19 in Zhejiang from January to February 2020 were collected and the clinical and epidemiological characteristics were analyzed retrospectively.Results All 21 patients were middle-aged and elderly women,aged(58.94±7.45)years,10(47.6%)had basic diseases,only one patient was diagnosed as a severe case,and the rest were mild cases,and no patients died during this period.The most common symptoms at the time of onset were fever(19[90.5%]),cough(15[71.4%]),sputum(9[42.8%]),rare symptoms included fatigue(1[4.7%]),diarrhea(1[4.7%])and headache(1[4.7%]),the median time from exposure to disease onset was 7(3-11.5)days.At admission,albumin decreased in 57.14%(12/21),sodium decreased in 42.85%(9/21),urea nitrogen decreased in 38.09%(8/21),and lymphopenia decreased in 28.57%(6/21).14.28%(3/21)of patients had decreased potassium and leukocytes.In addition,patients with elevated blood glucose,C-reactive protein,serum lactate dehydrogenase and transaminase accounted for 61.90%(13/21),61.90%(13/21),33.33%(7/21)and 23.80%(5/21),respectively.All patients had abnormal changes in lung CT examination at admission,and the imaging findings were mostly bilateral lung infections with ground glass/spot-like changes.Conclusion The onset of this cluster case is mainly among elderly women.Group aggregation can lead to the spread of COVID-19,and the elderly people are more susceptible.Large-scale gatherings should be restricted during unusual periods to reduce personnel mobility and contact,thus contributing to disease control.