新型冠状病毒肺炎12例死亡病例分析及文献回顾

Analysis and literature review of 12 cases of human infection with COVID-19

探讨12例新型冠状病毒肺炎(COVID-19)死亡患者的临床特点,分析其死亡风险的影响因素,建立COVID-19患者危险因素评估表,提高对重症病例诊治的认识,为该病的早期防控提供指导。对2020年1月至2020年3月在黄冈市中心医院收治的12例COVID-19死亡患者的临床资料进行回顾性分析。结果显示:12例COVID-19死亡患者发病年龄较大,男性为主,年龄50~86岁,有基础疾病,首发症状为发热、咳嗽、乏力,逐渐加重时出现胸闷气促,并发多器官损害。入院前COVID-19患者白细胞计数与死亡前比较,差异无显著性,入院前COVID-19患者淋巴细胞计数、D2聚体、肌酐、谷丙转氨酶(ALT)及谷草转氨酶(AST)的均值与其死亡前相比差异有显著性。结果提示年龄大且有基础疾病的男性患者感染新型冠状病毒后死亡率可能更高,同时COVID-19患者入院出现呼吸困难,氧合指数下降,淋巴细胞计数或者淋巴细胞比率逐渐下降,C反应蛋白(CRP)、D2聚体逐渐升高时其死亡风险可能增加,故早期评估可以很好地预测疾病的严重程度。

To explore the clinical characteristics of 12 patients dying from Novel coronavirus Pneumoni(COVID-19),analyze the influencing factors of death risk,establish a risk factor assessment table for patients with COVID-19,improve the understanding of diagnosis and treatment of severe cases,and provide guidance for the early prevention and control of the disease.The clinical data of 12 patients with COVID-19 death admitted to Huanggang Central Hospital from January 2020 to March 2020 were retrospectively analyzed.According to the results,12 patients with COVID-19 deaths were older,male,with age between 50-86 years old,have basic diseases,starting symptoms are fever,cough,fatigue,gradually aggravate occurrence bosom,short breath,were easily complicated by multiple organ damage,and there was no significant difference between the average white blood cell count of COVID-19 patients before admission and the average white blood cell count before death,while there were significant differences between the average lymphocyte count,D2 mer,creatinine,Alanine transaminase(ALT)and Glutamic oxaloacetic acid transferase(AST)of COVID-19 patients before admission and that before death.Results suggest older men having basic diseases infected with coronavirus might have a higher mortality rate,at the same time,in COVID-19 patients admitted to hospital dyspnea,oxygenation index decrease,lymphocyte count or lymphocyte ratio gradually declining,c-reactive protein(CRP)and D2 polymers increase may increase their risk of death,and the early assessment is a good way to predict the severity of the disease.