2019新型冠状病毒肺炎确诊病例特征分析

Characteristic Analysis of Patients with Coronavirus Disease 2019 in the Early Stage

目的:分析COVID-19肺炎患者早期临床、血液学和影像学特征。方法:回顾性收集2020年1月22日至3月14日十堰市太和医院确诊的202例COVID-19肺炎成人患者相关流行病学、早期临床表现、血液学和影像学资料,应用SPSS 22.0软件进行数据分析。结果:202例COVID-19肺炎确诊患者中位年龄为40.50岁,男性54􀆰46%;临床以普通型为主(占77.72%),重症率12.38%,病死率1.49%。68.81%的患者有流行病学史。临床表现以感染中毒症状(发热67.82%、乏力28.71%、肌痛17.82%)为主;干咳(28.22%)、咳痰(27.72%)和咽痛(16􀆰83%)常见;消化道症状者占20.30%。39.60%的患者出现淋巴细胞减少;CRP和ESR升高的患者分别为70􀆰79%和47􀆰52%;37.62%的患者D-二聚体升高;29.70%的患者LDH升高。分别有12.87%和12.38%的患者出现轻微肝损害和肾功能损伤。122例患者胸部CT检查符合病毒性肺炎征象。23.76%的患者合并基础疾病(高血压12.87%、糖尿病5.45%、冠心病4.95%)。结论:十堰市太和医院确诊的COVID-19肺炎患者以普通型为主,外周血淋巴细胞计数减少较为常见;CRP及D-二聚体升高,ESR增快是普遍现象;胸部CT表现为典型的多发斑片状磨玻璃影,半数患者合并普通呼吸道病毒感染。

Objective To analyze the early clinical, hematological and imaging characteristics of patients with coronavirus diseases 2019(COVID-19). Methods 202 adult patients diagnosed with COVID-19 in Shiyan Taihe hospital from January 22, 2020 to March 14, 2020 were included in the present retrospective study. The data of epidemiology, early clinical manifestations, blood biochemistry and imaging characteristics were analyzed using SPSS 22.0 software. Results Among the 202 patients with COVID-19, 54.46% was males with a median age of 40.50 years. The clinical type was mainly ordinary type(77.72%) and severe type(12.38%), with a mortality of 1.49%. 68.81% of patients had an epidemiological history. The main clinical manifestations were the toxemic symptoms of infection(fever 67.82%, fatigue 28.71%, myalgia 17.82%), dry cough(28.22%), expectoration(27.72%) and sore throat(16.83%). Gastrointestinal symptoms accounted for 20.30%. Lymphocytopenia was found in 39.60% of the patients. Elevated serum CRP, ESR, D-dimer, and LDH were found in 70.79%, 47.52%, 37.62% and 29.70% of patients, respectively. There were 12.87% and 12.38% patients with mild liver damage and renal function damage. Chest CT examination of 122 patients was consistent with signs of viral pneumonia. Conclusion Most of the patients diagnosed with COVID-19 in Shiyan Taihe hospital showed typical clinical manifestations of ordinary type, and the decrease of peripheral blood lymphocyte count and the increase of CRP, D-dimer and ESR were common phenomenon. Chest CT showed typical multiple patchy ground glass shadow. Half of the patients were complicated with common respiratory tract virus infection.